Corticoids in Severe Community-Acquired Pneumonia (CAP)
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Purpose
The purpose of this study is to assess the efficacy of glucocorticoids as an adjuvant therapy in patients with severe community-acquired pneumonia (CAP) (Fine V). The hypothesis of the study is that glucocorticoids can modulate the excessive inflammatory response in patients with severe CAP without any significant side effects, showing a benefit in the percentage of non-response to the empiric antimicrobial treatment.
| Condition | Intervention | Phase |
|---|---|---|
|
Community-Acquired Pneumonia |
Drug: methylprednisolone Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Corticoids in Severe Community-acquired Pneumonia |
- Rate of non-response to empiric antimicrobial treatment [ Time Frame: 5 days ] [ Designated as safety issue: No ]
| Enrollment: | 120 |
| Study Start Date: | January 2004 |
| Study Completion Date: | March 2012 |
| Primary Completion Date: | February 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: methylprednisolone
methylprednisolone 0.5 mg/kg body weight every 12 h for 5 days
|
Drug: methylprednisolone
methylprednisolone 0.5 mg/kg body weight every 12 h for 5 days
Other Name: solumoderin
|
| Placebo Comparator: Placebo |
Drug: Placebo
Sodium chloride 0.9% 10 mL every 12 h for 5 days
Other Name: sodium chloride
|
Detailed Description:
Community acquired pneumonia (CAP) is associated with a local and systemic inflammatory response conducted by different pro and counter inflammatory cytokines. The evolution of the infection is mainly dependent on the intensity of the inflammatory response. The AIM of the project is to determine the clinical usefulness of methylprednisolone treatment (0,5 mg/ Kg weight every 12h for 5 days in patients with severe CAP and an excessive inflammatory response( patients identified based on a cut-off point of the reactive C protein (RCP) of 15 mg/dl). A randomized double blind placebo controlled study with two arms will be performed: The study group (patients with excessive inflammatory response) will receive methylprednisolone + antibiotics. Control group will receive placebo + antibiotics. Patients older than 18 years with Fine V pneumonia will be recruited. Clinical data and prognostic factors (APACHE II and, SOFA scores, etiology, mortality at ICU and at 28 days) will be collected.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Severe community-acquired pneumonia Fine V
- CRP >=15 mg/100 mL
Exclusion Criteria:
- Major contraindications for corticosteroids, such as uncontrolled diabetes, immunosuppression
- Previous glucocorticoid treatment during the previous month
- Documented extrapulmonary infection
- Previous hospitalization in the previous month
Contacts and Locations| Spain | |
| Servei Pneumoloiga. Hospital Clinic | |
| Barcelona, Catalunya, Spain, 08036 | |
| Servei Pneumologia. Hospital Clinic | |
| Barcelona, Catalunya, Spain, 08036 | |
| Hospital Clinic | |
| Barcelona, Spain, 08036 | |
| Principal Investigator: | Carlos Agusti, MD | Hospital Clinic, Barcelona,Spain. |
More Information
Additional Information:
No publications provided
| Responsible Party: | Carlos Agusti, Consultor Senior, Hospital Clinic of Barcelona |
| ClinicalTrials.gov Identifier: | NCT00908713 History of Changes |
| Other Study ID Numbers: | FIS 2003-CA |
| Study First Received: | May 26, 2009 |
| Last Updated: | March 19, 2013 |
| Health Authority: | Spain: Ministry of Health and Consumption |
Keywords provided by Hospital Clinic of Barcelona:
|
Severe CAP Adjuvant therapy Glucocorticoids CAP Fine V with C-reactive protein >= 15 mg/100 mL |
Additional relevant MeSH terms:
|
Pneumonia Lung Diseases Respiratory Tract Diseases Respiratory Tract Infections Methylprednisolone acetate Prednisolone acetate Methylprednisolone Methylprednisolone Hemisuccinate Prednisolone Prednisolone hemisuccinate Prednisolone phosphate Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions |
Antiemetics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Neuroprotective Agents Protective Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 21, 2013