The European respiratory journal. Supplement最新文献

{"title":"Cumulative corticosteroid-sparing effect of anti-interleukin-5/5Ra in eosinophilic asthma","authors":"J. A. Kroes, Sybrand W.J. Zielhuis, K. de Jong, S. Hashimoto, J. Sont, S. Zielhuis, E. V. van Roon, E. Bel, A. ten Brinke","doi":"10.1183/13993003.02983-2021","DOIUrl":"https://doi.org/10.1183/13993003.02983-2021","url":null,"abstract":"Background Anti-interleukin (IL)-5/IL-5 receptor α (IL-5Ra) therapy has been shown to reduce maintenance oral corticosteroid (OCS) dose in severe eosinophilic asthma. However, the effect on cumulative OCS exposure is currently unknown. Neither is it known how prior OCS exposure affects response to anti-IL-5/5Ra treatment. We aimed primarily to compare the cumulative OCS exposure over a 2-year period before and after anti-IL-5/5Ra initiation, and secondarily to investigate whether duration and cumulative OCS exposure prior to anti-IL-5/5Ra influence the ability to discontinue OCS within 2 years of anti-IL-5/5Ra therapy. Methods This real-world nationwide observational registry-based study evaluated all dispensed OCS from 389 adults with severe eosinophilic asthma included in the Dutch Severe Asthma Registry (RAPSODI) 2 years before and 2 years after initiating anti-IL-5/5Ra. The Wilcoxon signed-rank test and multivariable regression analyses were used. Results Median (interquartile range) cumulative OCS exposure in the 2 years before and after anti-IL-5/5Ra initiation decreased from 2.715 (1.150–5.539) to 1.050 (0.300–3.640) g (p<0.001). 52% of patients were able to discontinue OCS within 2 years after anti-IL-5/5Ra therapy, which was independently predicted by lower and shorter prior OCS exposure. Conclusions This real-world study showed that anti-IL-5/5Ra therapy leads to a significant reduction in cumulative OCS exposure over a 2-year period. Patients with lower and shorter OCS exposure were more likely to completely eliminate OCS. Since cumulative exposure increased progressively prior to anti-IL-5/5Ra initiation, our data suggest that early intervention leads to a better long-term prognosis in patients with severe eosinophilic asthma. Anti-IL-5/5Ra therapy leads to a reduction in cumulative oral corticosteroid exposure over a 2-year period. This study suggests that early anti-IL-5/5Ra intervention leads to a better long-term prognosis in patients with severe eosinophilic asthma. https://bit.ly/3jzVGqw","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86809093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leukotriene receptor antagonists and risk of neuropsychiatric events in children, adolescents and young adults: a self-controlled case series","authors":"Ji Soo Park, Yoo-Jung Cho, J. Yun, H. Lee, Jinho Yu, H. Yang, D. Suh","doi":"10.1183/13993003.02467-2021","DOIUrl":"https://doi.org/10.1183/13993003.02467-2021","url":null,"abstract":"Background Leukotriene receptor antagonists (LTRAs) are widely used for asthma and allergic rhinitis (AR), but concerns about the risk of neuropsychiatric events (NPEs) have been raised since the first Drug Safety Communication by the US Food and Drug Administration in 2008. This study evaluates the association between LTRA use and NPEs in children, adolescents and young adults with asthma or AR. Methods A self-controlled case series study was conducted using the Korean National Health Insurance Service claims database from two 3-year observation periods (observation period 1 (Obs1): 2005–2007; observation period 2 (Obs2): 2016–2018). Asthma or AR patients aged 3–30 years who were prescribed LTRAs and diagnosed with NPEs were included. The incidence rate ratios (IRRs) for the exposed period and risk periods (1–3, 4–7, 8–14, 15–30, 31–90 and >90 days from initiation of LTRA) compared with unexposed periods were calculated using conditional Poisson regression. Subgroup analysis according to age group, type of NPEs and indication of LTRA was performed. Results Among 17 001 included patients, the risk of NPEs increased in Obs2 (IRR 1.11, 95% CI 1.00–1.22), but did not increase in Obs1. Risk was increased during risk periods 4–7 days (IRR 2.36, 95% CI 1.99–2.76) and 8–14 days (IRR 1.78, 95% CI 1.46–2.15) after initiation of LTRA, particularly in adolescents (IRR 1.28, 95% CI 1.05–1.55) and young adults (IRR 1.14, 95% CI 1.02–1.28), while risk was decreased in children (3–11 years). Risk was not increased for any single type of NPE. AR patients were at increased risk (IRR 1.19, 95% CI 1.01–1.39), but not those with asthma. Conclusions Overall, risk of NPEs with LTRA use differed between risk periods and subgroups. Physicians should prescribe LTRAs according to indications and inform patients about possible NPEs. Risk of neuropsychiatric events associated with leukotriene receptor antagonist use differs between risk periods and age groups. Risk is increased 4–14 days after initiation of the medication in adolescents and young adults, but not in children. https://bit.ly/3kcKFvE","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91133527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgA+ memory B-cells are significantly increased in patients with asthma and small airway dysfunction","authors":"A. Habener, R. Grychtol, S. Gaedcke, D. DeLuca, A. Dittrich, C. Happle, M. Abdo, H. Watz, F. Pedersen, I. König, D. Thiele, M. Kopp, E. von Mutius, T. Bahmer, K. Rabe, A. Meyer‐Bahlburg, G. Hansen, Oliver Barbara Nils Naschla Johanna Katja Kristina Nicole Fuchs Roesler Welchering Kohistani-Greif Kurz Land","doi":"10.1183/13993003.02130-2021","DOIUrl":"https://doi.org/10.1183/13993003.02130-2021","url":null,"abstract":"Background Comprehensive studies investigated the role of T-cells in asthma which led to personalised treatment options targeting severe eosinophilic asthma. However, little is known about the contribution of B-cells to this chronic inflammatory disease. In this study we investigated the contribution of various B-cell populations to specific clinical features in asthma. Methods In the All Age Asthma Cohort (ALLIANCE), a subgroup of 154 adult asthma patients and 28 healthy controls were included for B-cell characterisation by flow cytometry. Questionnaires, lung function measurements, blood differential counts and allergy testing of participants were analysed together with comprehensive data on B-cells using association studies and multivariate linear models. Results Patients with severe asthma showed decreased immature B-cell populations while memory B-cells were significantly increased compared with both mild–moderate asthma patients and healthy controls. Furthermore, increased frequencies of IgA+ memory B-cells were associated with impaired lung function and specifically with parameters indicative for augmented resistance in the peripheral airways. Accordingly, asthma patients with small airway dysfunction (SAD) defined by impulse oscillometry showed increased frequencies of IgA+ memory B-cells, particularly in patients with mild–moderate asthma. Additionally, IgA+ memory B-cells significantly correlated with clinical features of SAD such as exacerbations. Conclusions With this study we demonstrate for the first time a significant association of increased IgA+ memory B-cells with asthma and SAD, pointing towards future options for B-cell-directed strategies in preventing and treating asthma. Circulating B-cells are altered in asthma patients. In particular, IgA+ memory B-cells are significantly increased in patients with impaired lung function, especially of the small airways, suggesting a contribution to inflammation in the peripheral lung. https://bit.ly/3r0xBNA","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"9 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80143548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer risk in adherent users of polyurethane foam-containing CPAP devices for sleep apnoea","authors":"G. Justeau, C. Gervès-Pinquié, M. Jouvenot, T. Pigeanne, S. Launois, L. Leclair-Visonneau, P. Masson, A. Bizieux-Thaminy, S. Bailly, N. Meslier, A. Sabil, J. Racineux, W. Trzepizur, F. Gagnadoux","doi":"10.1183/13993003.00551-2022","DOIUrl":"https://doi.org/10.1183/13993003.00551-2022","url":null,"abstract":"On 14 June, 2021 Philipps Respironics (PR) emitted a voluntary recall notification for several sleep and respiratory care products, including continuous positive airway pressure (CPAP) devices used for obstructive sleep apnoea (OSA) therapy and ventilators. The polyester-based polyurethane (PE-PUR) sound abatement foam may break down into particles, which may enter the device's air tube and be inhaled or swallowed by the user. The volatile gas products (diethylene glycol, toluene di-isocyanate isomers, toluene diamine isomers) released during the degradation process have been suspected to present potential toxic and carcinogenic effects [1]. Whether prolonged exposure to these volatile compounds is associated with an increased risk of cancer in patients using PR devices for OSA is a crucial issue. Using clinical data from a retrospective longitudinal multicentre cohort linked with health administrative data, Kendzerska et al. [2] reported no increased all-cancer risk in 1220 patients treated for OSA with a PR device over a median follow-up time of 7.5 years. However, the lack of therapy adherence data did not make it possible to evaluate cancer risk in CPAP-adherent patients. Using propensity score matching within a nationwide study of patients with OSA, Palm et al. [3] reported an increased all-cancer and lung cancer incidence in counties prescribing ≥80% of CPAP devices containing polyurethane foam (PUF-CPAP) compared to patients from counties prescribing <10% of PUF-CPAP. However, the association disappeared in the sensitivity analysis excluding a Swedish county with known higher smoking rates. Sustained and adherent CPAP therapy of obstructive sleep apnoea using Philips Respironics devices containing polyester-based polyurethane foam, was not associated with an increased risk of cancer after a median follow-up time of 7.2 years https://bit.ly/3vBpUQE","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77249069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifapentine access in Europe: growing concerns over key tuberculosis treatment component","authors":"L. Guglielmetti, G. Günther, C. Leu, D. Cirillo, R. Duarte, A. García-Basteiro, D. Goletti, M. Jankovic, L. Kukša, F. Maurer, F. Mechaï, Simon Tiberi, F. van Leth, N. Veziris, C. Lange","doi":"10.1183/13993003.00388-2022","DOIUrl":"https://doi.org/10.1183/13993003.00388-2022","url":null,"abstract":"Rifapentine, a synthetic derivate of rifampicin which was developed in 1965, has interesting pharmacological properties, including a long terminal half-life (13 h, compared to 2–3 h for rifampicin) and promising bactericidal activity against Mycobacterium tuberculosis. Despite being approved in 1998 by the US Food and Drug Administration (FDA) for the treatment of pulmonary tuberculosis, its global use has been limited by unavailability. In the past decade, new evidence has emerged to define rifapentine as a key component for treatment of active disease and latent infection with M. tuberculosis (LTBI). Lack of access to rifapentine in Europe denies patients optimal care for active tuberculosis and latent tuberculosis infection, and deprives healthcare providers of adequate tools to pursue tuberculosis control and elimination https://bit.ly/3jz85eh","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74195090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab efficacy and safety in patients with asthma and blood eosinophils ≥500 cells·µL−1","authors":"K. Rabe, I. Pavord, M. Castro, M. Wechsler, N. Daizadeh, U. Kapoor, B. Ortiz, A. Radwan, Robert R. Johnson, P. Rowe, Y. Deniz, J. Jacob-Nara","doi":"10.1183/13993003.02577-2021","DOIUrl":"https://doi.org/10.1183/13993003.02577-2021","url":null,"abstract":"Uncontrolled, moderate-to-severe asthma in patients with high baseline blood eosinophils (≥500 cells·µL−1) can be difficult to treat [1]. Global Initiative for Asthma guidelines recommend biologics as add-on therapy for patients with severe type 2 inflammatory asthma that remains uncontrolled despite treatment with high-dose inhaled corticosteroids [2]. Surrogate markers of type 2 inflammation, such as elevated levels of blood or sputum eosinophils and fractional exhaled nitric oxide (FeNO) can be used to identify patients with a type 2 signature who might be eligible for such treatment [1–3]. Several biologics are now available that target different molecules in type 2 inflammatory pathways, notably IgE and type 2 cytokines [1–3]. One of these, dupilumab, is a fully human VelocImmune-derived [4, 5] monoclonal antibody that blocks the shared receptor component for interleukin-4 and -13, cytokines that are key and central drivers of type 2 inflammation in multiple diseases, thus inhibiting their signalling [6, 7]. Dupilumab is well tolerated and improves clinical outcomes in patients with asthma and high eosinophils (≥500 cells·µL−1). Improvements in clinical outcomes correlate with eosinophil counts, demonstrating dupilumab efficacy in those with high eosinophils. https://bit.ly/3Jxvicb","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75110589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The curious incident of long COVID symptoms, from an imaginary condition to a recognised syndrome: a “small victory”","authors":"V. D. Di Mattei, G. Perego, Francesca Milano, Thomas Eric Hill, S. Harari","doi":"10.1183/13993003.00653-2022","DOIUrl":"https://doi.org/10.1183/13993003.00653-2022","url":null,"abstract":"Over the past 2 years, the scientific community has acquired a better understanding about coronavirus disease 2019 (COVID-19) as an acute disease, but there is still much to learn, especially when considering the chronic aspects of this illness. In the early stages of the pandemic, healthcare workers focused on acute COVID-19 symptoms, often overlooking its long-term and chronic implications. In October 2021, the World Health Organization recognised these long-term complications as long COVID syndrome, which probably affected more than 62% of patients [1]. Patients with long COVID syndrome experienced the fear of living forever with those symptoms, arising from the lack of medical information on this issue [2], combined with the feeling of being ignored and disbelieved. Several patients felt they did not have access to appropriate healthcare, as they perceived that healthcare workers disregarded their symptoms and judged them as unreal, often considering them secondary to psychiatric issues [3]. In the early stages of the pandemic, patients with a post-COVID condition felt ignored and disbelieved by their doctors and relatives. Given the importance of the doctor–patient relationship in post-COVID management, we recommend “relationship-based care”. https://bit.ly/3vQ9RO1","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84570039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential and challenges of radiomics in uncovering prognostic and molecular differences in interstitial lung disease associated with systemic sclerosis","authors":"Lu Zhang, Jieling Zheng, Zhe Jin, Qiuying Chen, Shuyi Liu, Bin Zhang","doi":"10.1183/13993003.02792-2021","DOIUrl":"https://doi.org/10.1183/13993003.02792-2021","url":null,"abstract":"We read with great interest the study by Schniering et al. [1], recently published in the European Respiratory Journal. This study highlighted the potential of radiomics as a non-invasive tool for disease characterisation, prognosis stratification and lung pathophysiology evaluation in systemic sclerosis-associated interstitial lung disease (SSc-ILD). The results demonstrated that quantitative radiomic risk score (qRISSc) could accurately predict survival in SSc-ILD cohorts and was reverse translatable from human to animal ILD and correlated with fibrotic pathway activation. To the best of our knowledge, this is the first landmark study to validate the biological meaning of radiomic biomarkers through a cross-species approach, which may provide new insights into future radiomic works to break through the current bottleneck of traditional radiomics. The radiomic risk score is promising but challenging in the evaluation of prognostic and molecular differences in interstitial lung disease associated with systemic sclerosis. https://bit.ly/3oWg4UO","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"15 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83732054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma remission: what is it and how can it be achieved?","authors":"Dennis Thomas, V. McDonald, I. Pavord, P. Gibson","doi":"10.1183/13993003.02583-2021","DOIUrl":"https://doi.org/10.1183/13993003.02583-2021","url":null,"abstract":"Asthma treatment goals currently focus on symptom and exacerbation control rather than remission. Remission is not identical to cure, but is a step closer. This review considers the current definitions of remission in asthma, the prevalence and predictors, the pathophysiology of remission, the possibility of achieving it using the available treatment options, and the future research directions. Asthma remission is characterised by a high level of disease control, including the absence of symptoms and exacerbations, and normalisation or optimisation of lung function with or without ongoing treatment. Even in those who develop a symptomatic remission of asthma, persistent pathological abnormalities are common, leading to a risk of subsequent relapse at any time. Complete remission requires normalisation or stabilisation of any underlying pathology in addition to symptomatic remission. Remission is possible as part of the natural history of asthma, and the prevalence of remission in the adult asthma population varies between 2% and 52%. The factors associated with remission include mild asthma, better lung function, better asthma control, younger age, early-onset asthma, shorter duration of asthma, milder bronchial hyperresponsiveness, fewer comorbidities and smoking cessation or never smoking. Although previous studies have not targeted treatment-induced remission, there is some evidence to show that the current long-term add-on therapies such as biologics and azithromycin can achieve some criteria for asthma remission on treatment, at least in a subgroup of patients. However, more research is required. Long-term remission could be included as a therapeutic goal in studies of asthma treatments. As we are moving through a new era of highly effective targeted biologics, macrolides and precision medicine in asthma management, it is logical to consider a paradigm shift in the treatment goals from asthma control to asthma remission https://bit.ly/3N9nEqN","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83483228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial","authors":"C. Salvarani, M. Massari, M. Costantini, D. Merlo, Gabriella Lucia Mariani, Pierluigi Viale, S. Nava, G. Guaraldi, G. Dolci, L. Boni, L. Savoldi, P. Bruzzi, Caterina Turrà, M. Catanoso, A. Marata, Chiara Barbieri, Annamaria Valcavi, Francesca Franzoni, S. Cavuto, G. Mazzi, R. Corsini, F. Trapani, A. Bartoloni, E. Barisione, Chiara Barbieri, G. Burastero, A. Pan, W. Inojosa, R. Scala, C. Burattini, F. Luppi, M. Codeluppi, Kamal Eldin Tarek, G. Cenderello, M. Salio, G. Foti, R. Dongilli, G. Bajocchi, E. Negri, G. Ciusa, Giacomo Fornaro, I. Bassi, L. Zammarchi, T. Aloè, N. Facciolongo","doi":"10.1183/13993003.00025-2022","DOIUrl":"https://doi.org/10.1183/13993003.00025-2022","url":null,"abstract":"Rationale Pulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia. Methods In this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1 g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival. Results Overall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30 days from randomisation. Median time to discharge was similar in both groups (15 days, 95% CI 13.0–17.0 days and 16 days, 95% CI 13.8–18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71–1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0% versus 16.1%; HR 1.26, 95% CI 0.74–2.16; p=0.176) or overall mortality (10.0% versus 12.2%; HR 0.83, 95% CI 0.42–1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups. Conclusions Methylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia. The quick and strong anti-inflammatory effect of pulse glucocorticoid therapy seems to be of no benefit in COVID-19 pneumonia https://bit.ly/3IkUmSn","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84666443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}