A systematic review and meta-analysis of steroid use for treatment of TB meningitis.

IF 3.1

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease Pub Date : 2026-06-29 DOI:10.5588/ijtld.25.0588

M J Nasiri, G Hamzelouee, M Rezaeinasab, H Souri, E Eghbal, N Ghafari, L D'Ambrosio, R Centis, V Venketaraman, G B Migliori

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Abstract

BACKGROUNDTB meningitis (TBM) is the most severe form of extra-pulmonary TB. This study evaluated the efficacy and safety of adjunctive steroid therapy in TBM.METHODSWe searched PubMed/MEDLINE, Embase, and Cochrane CENTRAL for controlled trials of steroids in TBM. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for mortality, neurological complications, functional recovery, and adverse events.RESULTSFourteen trials with 2,028 patients were included. Steroids reduced mortality in adults (RR = 0.83; 95% CI: 0.72-0.95) but not in children (RR = 0.68; 95% CI: 0.36-1.29). No significant benefit was seen for neurological complications (RR = 1.03; 95% CI: 0.74-1.44) or functional recovery (RR = 1.16; 95% CI: 0.86-1.57). Results were consistent across steroid types, doses, and routes.CONCLUSIONAdjunctive steroids reduce mortality in adult TBM but not in children, nor do they improve neurological or functional outcomes..

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使用类固醇治疗结核性脑膜炎的系统回顾和荟萃分析。

背景：结核性脑膜炎（TBM）是肺外结核最严重的形式。本研究评估了辅助类固醇治疗TBM的有效性和安全性。方法检索PubMed/MEDLINE、Embase和Cochrane CENTRAL中类固醇治疗TBM的对照试验。计算死亡率、神经系统并发症、功能恢复和不良事件的合并风险比（rr）和95%置信区间（ci）。结果纳入14项试验，2028例患者。类固醇降低了成人的死亡率（RR = 0.83; 95% CI: 0.72-0.95），但对儿童没有影响（RR = 0.68; 95% CI: 0.36-1.29）。在神经系统并发症（RR = 1.03; 95% CI: 0.74-1.44）或功能恢复（RR = 1.16; 95% CI: 0.86-1.57）方面未见明显益处。不同类固醇类型、剂量和途径的结果一致。结论：辅助类固醇可降低成人TBM的死亡率，但对儿童无效，也不能改善神经或功能预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

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