6/28/23, 10:00 PM ESCAPe Pathway Feedback Search Clinical Topics Home Studies ESCAPe ESCAPe Disease Community-acquired pneumonia Trial question What is the role of prolonged low-dose methylprednisolone in patients with severe community- acquired pneumonia? Study design Multi-center Double blinded RCT Population Characteristics of study participants 4.0% female N = 584 96.0% male 584 patients (21 female, 562 male) Inclusion criteria: adult patients with severe community-acquired pneumonia presenting in hospital within 72-96 hours Key exclusion criteria: vasopressor-dependent shock requiring multiple or high-dose vasopressors; major gastrointestinal bleeding; postoperative pneumonia; cystic fibrosis; active tuberculosis; fungal infection Interventions N=297 methylprednisolone (intravenous 40 mg loading bolus, followed by 40 mg/day through day 7 and progressive tapering during the 20-day treatment course) N=287 placebo (matching placebo for 20 days) Primary outcome Death from all causes at day 60 https://web.pathway.md/studies/rec0QZekarcSJ01Zj 1/2 6/28/23, 10:00 PM ESCAPe Pathway 18.0 % 18 16 13.5 % 9.0 % 4.5 % No significant difference 0.0 % Methylprednisolone Placebo No significant difference in death from all causes at day 60 (16% vs. 18%; aOR 0.9, 95% CI 0.57 to 1.4) Secondary outcomes No significant difference in death in the hospital (12% vs. 10%; AD 2%, 95% CI -3 to 7) Safety outcomes No significant difference in serious adverse events. Conclusion In adult patients with severe community-acquired pneumonia presenting in hospital within 72-96 hours, methylprednisolone was not superior to placebo with respect to death from all causes at day 60. Reference G Umberto Meduri, Mei-Chiung Shih, Lisa Bridges et al. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia. Intensive Care Med. 2022 Aug;48(8):1009-102. Open reference URL https://web.pathway.md/studies/rec0QZekarcSJ01Zj 2/2