tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Nov 24;10(12)
fad571.
doi: 10.1093/ofid/ofad571. eCollection 2023 Dec. Effect of Inhaled Ciclesonide in Non-Critically Ill Hospitalized Patients With Coronavirus Disease 2019: A Multicenter Observational Study in Japan
Jun Suzuki[SUP] 1 2 3 [/SUP], Shiro Endo[SUP] 2 3 4 [/SUP], Takayuki Suzuki[SUP] 1 [/SUP], Teppei Sasahara[SUP] 1 5 [/SUP], Shuji Hatakeyama[SUP] 1 6 [/SUP], Yuji Morisawa[SUP] 1 [/SUP], Mineji Hayakawa[SUP] 7 [/SUP], Kazuma Yamakawa[SUP] 8 [/SUP], Akira Endo[SUP] 9 [/SUP], Takayuki Ogura[SUP] 10 [/SUP], Atsushi Hirayama[SUP] 11 [/SUP], Hideo Yasunaga[SUP] 12 [/SUP], Takashi Tagami[SUP] 13 [/SUP]
Affiliations
Background: Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Although systemic steroids play an important role in treating patients with severe COVID-19, the role of inhaled corticosteroids in non-critically ill, hospitalized patients with COVID-19 remains unclear.
Methods: We analyzed findings in non-critically ill, hospitalized patients with COVID-19 who were >18 years old and were admitted to 64 Japanese hospitals between January and September 2020. We performed propensity score matching analysis to evaluate 28-day and in-hospital mortality rates with or without inhaled ciclesonide within 2 days of admission. Sensitivity analyses using inverse probability weighting analysis, and generalized estimating equation method were also performed.
Results: Eligible patients (n = 3638) were divided into ciclesonide (n = 290) and control (n = 3, 393) groups. The 1-to-4 propensity score matching analysis included 271 ciclesonide users and 1084 nonusers. There were no significant differences between the 2 groups for 28-day (3.3% vs 2.3%; risk difference, 1.0% [95% confidence interval, -1.2 to 3.3]) or in-hospital (4.8% vs 2.6%; risk difference, 2.2 [-.5 to 4.9]) mortality rates. The sensitivity analysis showed similar outcomes.
Conclusions: From this multicenter observational study in Japan, inhaled ciclesonide did not decrease 28-day or in-hospital mortality rates in non-critically ill, hospitalized patients with COVID-19. Future large, multinational, randomized trials are required to confirm our results.
Keywords: COVID-19; SARS-CoV-2; ciclesonide; inhaled corticosteroid; mortality.
. 2023 Nov 24;10(12)
fad571.doi: 10.1093/ofid/ofad571. eCollection 2023 Dec. Effect of Inhaled Ciclesonide in Non-Critically Ill Hospitalized Patients With Coronavirus Disease 2019: A Multicenter Observational Study in Japan
Jun Suzuki[SUP] 1 2 3 [/SUP], Shiro Endo[SUP] 2 3 4 [/SUP], Takayuki Suzuki[SUP] 1 [/SUP], Teppei Sasahara[SUP] 1 5 [/SUP], Shuji Hatakeyama[SUP] 1 6 [/SUP], Yuji Morisawa[SUP] 1 [/SUP], Mineji Hayakawa[SUP] 7 [/SUP], Kazuma Yamakawa[SUP] 8 [/SUP], Akira Endo[SUP] 9 [/SUP], Takayuki Ogura[SUP] 10 [/SUP], Atsushi Hirayama[SUP] 11 [/SUP], Hideo Yasunaga[SUP] 12 [/SUP], Takashi Tagami[SUP] 13 [/SUP]
Affiliations
- PMID: 38075018
- PMCID: PMC10709541
- DOI: 10.1093/ofid/ofad571
Background: Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Although systemic steroids play an important role in treating patients with severe COVID-19, the role of inhaled corticosteroids in non-critically ill, hospitalized patients with COVID-19 remains unclear.
Methods: We analyzed findings in non-critically ill, hospitalized patients with COVID-19 who were >18 years old and were admitted to 64 Japanese hospitals between January and September 2020. We performed propensity score matching analysis to evaluate 28-day and in-hospital mortality rates with or without inhaled ciclesonide within 2 days of admission. Sensitivity analyses using inverse probability weighting analysis, and generalized estimating equation method were also performed.
Results: Eligible patients (n = 3638) were divided into ciclesonide (n = 290) and control (n = 3, 393) groups. The 1-to-4 propensity score matching analysis included 271 ciclesonide users and 1084 nonusers. There were no significant differences between the 2 groups for 28-day (3.3% vs 2.3%; risk difference, 1.0% [95% confidence interval, -1.2 to 3.3]) or in-hospital (4.8% vs 2.6%; risk difference, 2.2 [-.5 to 4.9]) mortality rates. The sensitivity analysis showed similar outcomes.
Conclusions: From this multicenter observational study in Japan, inhaled ciclesonide did not decrease 28-day or in-hospital mortality rates in non-critically ill, hospitalized patients with COVID-19. Future large, multinational, randomized trials are required to confirm our results.
Keywords: COVID-19; SARS-CoV-2; ciclesonide; inhaled corticosteroid; mortality.