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Low Doses Corticosteroids as Adjuvant Therapy for the Treatment of Severe H1N1 Flu

Phase 3
Terminated
Conditions
Pneumonia, Viral
Influenza in Humans
Interventions
Drug: isotonic saline
Registration Number
NCT01014364
Lead Sponsor
University of Versailles
Brief Summary

The H1N1 flu pandemic is one of the major infectious threat of the past half century. it is rapidly progressing worldwide and a substantial number of patients get severe H1N1 related pneumonia that requires mechanical ventilation and admission to the intensive care unit. The acute respiratory distress syndrome is associated with a substantial mortality and morbidity partly as a consequence of uncontrolled lung and systemic inflammation. many physicians are trying to counteract this pro-inflammatory storm by the use of corticosteroids albeit these drugs may cause super infection or metabolic disorders. Thus, there is a need for a randomized double blind, placebo controlled trial to define the benefit to risk ratio of corticosteroids in this patient.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • age above 15 years old
  • admitted to intensive care unit
  • proven or strong suspicion of H1N1 Influenza infection
  • diffuse pneumonia (for less than 96 hours)
  • need for non invasive or invasive mechanical ventilation
Exclusion Criteria
  • pregnancy
  • an age of 15 or less
  • rapidly fatal underlying disease with a life expectancy of one month or less
  • more than 3 organ dysfunction upon admission
  • previous treatment with corticosteroids (ie prednisone 30 mg per day or more, or equivalent, for at least one month)
  • formal indication for corticosteroids (eg Addison disease, status asthmaticus)
  • already on corticosteroids for 2 days or more in the management of the current episode
  • acute lung injury not related to viral pneumonia
  • presence of H1N1 related acute myocarditis or encephalitis
  • receiving antiviral treatment for more than 5 days

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Controlisotonic salineisotonic saline
CorticosteroidshydrocortisoneHydrocortisone
Primary Outcome Measures
NameTimeMethod
in hospital all cause moralityhospital discharge up to 90 days
Secondary Outcome Measures
NameTimeMethod
6 month all cause mortality180 days
intensive care unit free dayshospital discharge up to 90 days
proportion of patients with secondary infectionshospital discharge up to 90 days
mechanical ventilation free dayshospital discharge up to 90 days
proportion of patients who require ECMOhospital discharge up to 90 days
90 day all cause mortality90 day
28 day mortality28 day
respiratory function and health status180 days

Trial Locations

Locations (1)

Raymond Poincaré hospital

🇫🇷

Garches, France

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