Respiratory failure & ventilation
Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial
An erratum to this article was published (Lancet Respir Med, Sep 2025 ↗)
Primary resultResult — go to the resultMean difference 10.9% 95% CI −0.9 to 22.5Authors' conclusion
In immunocompromised HIV-negative patients with P jirovecii pneumonia, adjunctive corticosteroid treatment did not significantly decrease 28-day mortality.
Study context
- Population
- HIV-negative (non-AIDS) immunocompromised adults with P jirovecii pneumonia and acute hypoxaemic respiratory failure, 27 hospitals in Francerandomly assigned
- Participants
- 226 participants
- Comparison
- Adjunctive methylprednisolone for 21 days vs placebo
- Corticosteroidn = 112
- Placebon = 114reference
- Primary endpoint
- All-cause mortality (ITT)
- Follow-up
- 28 days
Methodological detailsmulticentre, double-blind, placebo-controlled
- Multicentre
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Mean difference
10.9%
95% CI −0.9 to 22.5
P = 0.069
Events by treatment group
Placebo vs Corticosteroid
mean difference 10.9% (95% CI −0.9 to 22.5); P = 0.069
Safety
| Outcome | Corticosteroid | Placebo |
|---|---|---|
| All secondary infections | 23.4% (95% CI 15.3–31.4) | 34.2% (95% CI 25.4–43.1) |
| Insulin needs | 30.8% (95% CI 22.3–40.5) | 22.5% (95% CI 15.1–31.4) |
Safety outcomes
- No significant differences in safety outcomes between groups
Original publication
Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. Published 10 July 2025. doi:10.
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