#corticoides

Kassem @kassem CC BY-NC-SA 11/02/2021

#Covid-19 : le #tocilizumab réduit le risque de décès, selon une étude
▻https://www.lemonde.fr/planete/article/2021/02/11/covid-19-le-tocilizumab-reduit-le-risque-de-deces-selon-une-etude_6069637_32
Étude #Recovery ;
patients en hypoxie ;
en association aux #corticoïdes (la plupart des patients du groupe témoin prenaient aussi des corticoïdes).
Les données « suggèrent que chez les patients Covid-19 présentant une hypoxie [manque d’apport en oxygène] et une inflammation importante, le traitement associant un corticostéroïde, tel que la dexaméthasone, et du tocilizumab réduit la mortalité d’environ un tiers chez les patients nécessitant de l’oxygène simple et de près de la moitié pour ceux nécessitant une ventilation mécanique invasive [respirateur] ».
Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY) : preliminary results of a randomised, controlled, open-label, platform trial | medRxiv
▻https://www.medrxiv.org/content/10.1101/2021.02.11.21249258v1

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Kassem @kassem CC BY-NC-SA 6/09/2020

A living WHO guideline on drugs for covid-19 | The BMJ
►https://www.bmj.com/content/370/bmj.m3379
Clinical question What is the role of drug interventions in the treatment and prevention of covid-19?
Recommendations The first version on this living guidance focuses on corticosteroids. It contains a strong recommendation for systemic corticosteroids in patients with severe and critical #covid-19, and a weak or conditional recommendation against systemic corticosteroids in patients with non-severe covid-19.
Corticosteroids are inexpensive and are on the World Health Organisation list of essential medicines.
#corticoides

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Kassem @kassem CC BY-NC-SA 3/09/2020

Les #corticoïdes efficaces dans les cas graves de #Covid-19 selon une étude [de l’#OMS]
▻https://www.ouest-france.fr/sante/virus/coronavirus/les-corticoides-efficaces-dans-les-cas-graves-de-covid-19-selon-une-etu
L’analyse regroupe des essais distincts de faibles doses d’hydrocortisone, de dexaméthasone et de méthylprednisolone, trois molécules de la famille des glycocorticoïdes, chez des patients hospitalisés en soins intensifs. Le taux de survie avoisine 68 % après un traitement aux corticostéroïdes contre environ 60 % en l’absence de ces molécules, précisent les auteurs de l’analyse dans un communiqué.

Kassem @kassem CC BY-NC-SA
- Kassem @kassem CC BY-NC-SA 3/09/2020
  
  3 publications sur le sujet (corticoïdes dans le COVID-19) sont apparues en même temps que celle de l’OMS.
  Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial | JAMA | JAMA Network
  ▻https://jamanetwork.com/journals/jama/fullarticle/2770278
  Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions.
  Effect of Hydrocortisone on 21-Day Mortality or Respiratory Support Among Critically Ill Patients With COVID-19: A Randomized Clinical Trial | JAMA | JAMA Network
  ▻https://jamanetwork.com/journals/jama/fullarticle/2770276
  Low-dose hydrocortisone did not significantly reduce treatment failure in patients with COVID-19–related acute respiratory failure; however, the study was stopped early and was therefore likely underpowered.
  Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial | JAMA | JAMA Network
  ▻https://jamanetwork.com/journals/jama/fullarticle/2770277
  Conclusions and Relevance Among patients with COVID-19 and moderate or severe ARDS, use of intravenous dexamethasone plus standard care compared with standard care alone resulted in a statistically significant increase in the number of ventilator-free days (days alive and free of mechanical ventilation) over 28 days.
  
  Kassem @kassem CC BY-NC-SA
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