Influence of Prednisone on Inflammatory Biomarkers in Community-Acquired Pneumonia: Secondary Analysis of a Randomized Trial.

Raess, Natalie; Schuetz, Philipp; Cesana-Nigro, Nicole; Winzeler, Bettina; Urwyler, Sandrine A; Schaedelin, Sabine; Rodondi, Nicolas; Blum, Manuel R.; Briel, Matthias; Mueller, Beat; Christ-Crain, Mirjam; Blum, Claudine A (2021). Influence of Prednisone on Inflammatory Biomarkers in Community-Acquired Pneumonia: Secondary Analysis of a Randomized Trial. (In Press). Journal of clinical pharmacology Sage Science Press 10.1002/jcph.1914

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Glucocorticoids are frequently prescribed in inflammatory diseases and have recently experienced a boom in the treatment of COVID-19. Small studies have shown an effect of glucocorticoids on inflammatory marker levels, but definitive proof is lacking. We investigated the influence of prednisone on inflammatory biomarkers in a previous placebo-controlled, randomized-controlled multicenter trial which compared a 7-day treatment course of 50 mg prednisone to placebo in patients hospitalized with community-acquired pneumonia (CAP). We compared levels of C-reactive protein (CRP), procalcitonin (PCT), leukocyte and neutrophil count between patients with and without glucocorticoid treatment at baseline and on days 3, 5, 7, and at discharge by Wilcoxon tests and variance analysis. 356 patient data sets in the prednisone group and 355 in the placebo group were available for analysis. Compared to placebo, use of prednisone was associated with reductions in levels of CRP on days 3, 5, and 7, (mean difference of 46%, p < 0.001 for each time point). For PCT, no such difference was observed. Leukocyte and neutrophil count were higher in the prednisone group at all time points (mean difference of 27% for leukocytes and 33% for neutrophils, p < 0.001 for all time points). We conclude that after administration of glucocorticoids in CAP, patients had lower CRP levels and increased leukocyte and neutrophil count as compared to the placebo group. PCT levels were not different between treatment groups. PCT levels thus may more appropriately mirror the resolution of infection compared to more traditional inflammatory markers. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Blum, Manuel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0091-2700

Publisher:

Sage Science Press

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

03 Jun 2021 20:23

Last Modified:

03 Jun 2021 21:46

Publisher DOI:

10.1002/jcph.1914

PubMed ID:

34031890

Uncontrolled Keywords:

C-reactive protein biomarkers glucocorticoids procalcitonin respiratory tract infections

BORIS DOI:

10.48350/156663

URI:

https://boris.unibe.ch/id/eprint/156663

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