Efficacy and safety of methylprednisolone against acute respiratory distress syndrome: A systematic review and meta-analysis.

Abstract

BACKGROUND:

Acute respiratory distress syndrome (ARDS) is caused by an inflammatory injury to the lung. Dysregulated inflammation is the cardinal feature of ARDS. Methylprednisolone is an option for treating ARDS. However, the benefits and adverse effects of methylprednisolone have not been well assessed in patients with ARDS. This study aimed to evaluate the efficacy and safety of methylprednisolone against ARDS.

MATERIAL AND METHODS:

The electronic database of Embase, PubMed, the Cochrane Library, CNKI, and Wanfang were searched, and randomized controlled trials (RCTs) reporting the efficacy and safety of methylprednisolone for ARDS were included. Revman 5.3 and Stata 15.0 were used to conduct the analysis. The fixed-effects model was used to calculate summary odds ratios (ORs) and 95% confidence interval (CIs).

RESULTS:

Ten RCTs studies involving 692 patients with ARDS. The summary results demonstrated that, compared with placebo, methylprednisolone had a statistically significant effect on mortality (OR = 0.64; 95% CI: 0.43-0.95, I2 = 42%); the time of mechanical ventilation (MD) = -2.70, 95% CI: -3.31 to -2.10; I2 = 0%) in patients with ARDS, but it was not associated with increased rates of adverse events (OR = 0.80; 95% CI: 0.34-1.86; I2 = 58%).

CONCLUSIONS:

This systematic review and meta-analysis demonstrated that Methylprednisolone is safe against ARDS. It may reduce mortality and shorten the time of mechanical ventilation. However, well-designed and large-sample studies were required to fully characterize the efficacy and safety of methylprednisolone against ARDS.

• Authors: Hai Lv, Linfeng Dai, Jun Lu, Lu Cheng, Yanxia Geng, Mingqi Chen, Qiuhua Chen, Xing Wang
• Journal: Medicine (Medicine (Baltimore)) Vol. 100 Issue 14 Pg. e25408 (Apr 09 2021) ISSN: 1536-5964 [Electronic] United States
• PMID: 33832136 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Anti-Inflammatory Agents
• Placebos
• Methylprednisolone

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Case-Control Studies
• Data Management
• Humans
• Inflammation (physiopathology)
• Methylprednisolone (adverse effects, therapeutic use)
• Middle Aged
• Mortality (trends)
• Placebos (administration & dosage)
• Randomized Controlled Trials as Topic
• Respiration, Artificial (statistics & numerical data)
• Respiratory Distress Syndrome (drug therapy, mortality, pathology)
• Safety
• Treatment Outcome