Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia : The REMAP-CAP Corticosteroid Domain Randomized Clinical Trial.

ABSTRACT:

Purpose

To determine whether hydrocortisone improves mortality in severe community-acquired pneumonia (CAP).

Methods

In an international adaptive randomized controlled platform trial testing multiple interventions, adults admitted to the intensive care unit (ICU) with severe CAP were randomized to a 7-day course of intravenous hydrocortisone (50 mg every 6 h) or control (no corticosteroid). The primary end point was 90-day all-cause mortality, analyzed iteratively by a Bayesian hierarchical model estimating distinct treatment effects for patients presenting with influenza (Y/N) and shock (Y/N).

Results

Fixed 7-day course hydrocortisone enrollment was stopped for futility (< 5% probability of > 20% relative improvement). Of 658 patients enrolled, 536 were randomized to

SUBMITTER: REMAP-CAP Investigators 

PROVIDER: S-EPMC12055926 | biostudies-literature | 2025 Apr

REPOSITORIES: biostudies-literature