ECE2015 Eposter Presentations Adrenal cortex (94 abstracts)
Influence of glucocorticoids on markers of inflammation in community-acquired pneumonia
Claudine A Blum 1, , Nicole Nigro 1 , Philipp Schuetz 3 , Bettina Winzeler 1 , Birsen Arici 1 , Julie Refardt 1 , Sandrine A Urwyler 1 , Matthias Briel 1, , Beat Mueller 3 & Mirjam Christ-Crain 1
1Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, Basel, Switzerland; 2Service d’Accueil des Urgences, CHU Pitié‐Salpêtrière et AP‐HP, Paris, France; 3Medical University Clinic, Departments of Internal and Emergency Medicine and Department of Endocrinology, Diabetology and Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland; 4Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Background: Glucocorticoids are frequently prescribed in inflammatory diseases. We investigated the influence of prednisone on classical and novel inflammatory markers in community-acquired pneumonia (CAP).
Methods: We evaluated levels of C-reactive protein (CRP), procalcitonin, leukocyte and neutrophil count in a prospective randomized, double-blind, placebo-controlled multicenter trial which compared prednisone 50 mg for 7 days to placebo in patients hospitalized with CAP. We performed Mann–Whitney U tests to compare biomarker levels between groups on day 1 before the first administration of prednisone and thereafter on days 3, 5, 7 and discharge.
Results: 335 patients in the prednisone group and 350 patients in the placebo group were evaluated. At baseline, all investigated markers levels did not differ between prednisone and placebo group. At days 3, 5, and 7, CRP levels were significantly lower in the prednisone group than in the placebo group (P<0.0001 for each time point). At hospital discharge, CRP levels were similar (P=0.53). For procalcitonin, this attenuating effect of steroids on circulating levels was not visible (P>0.05 for all points). Leukocyte and neutrophil count were higher in the prednisone group during administration of glucocorticoids (P<0.0001 for all time points including discharge).
Discussion: Administration of glucocorticoids in patients with CAP lowers CRP levels and increases leukocyte and neutrophil count, but has no influence on procalcitonin levels. Therefore, procalcitonin may be a more adequate inflammatory marker to measure treatment response in patients with an infectious disease receiving glucocorticoids.
Disclosure: This work was supported by the Swiss National Science Foundation (grant numbers PP0P3_123346, P2BSP3_155212, PP00P3_150531/1, 320030-138267, and 320030-150025), the Nora van Meeuwen Häfliger Stiftung, the Gottfried Julia Bangerter-Rhyner Stift.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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