A RECENT study reveals that cumulative doses of methylprednisolone (CMD), a commonly prescribed corticosteroid for connective tissue disease (CTD), may influence mortality risk from pneumonia, especially in cases of community-acquired pneumonia (CAP). Conducted across six hospitals in China, the study assessed 335 CTD patients who had developed pneumonia while on corticosteroid treatment, aiming to identify the optimal CMD range associated with the lowest mortality risk.
The study tracked mortality outcomes at 30 and 90 days post-pneumonia onset. Results showed a distinct nonlinear relationship between CMD and mortality: patients with CMDs ranging from 11 to 24 grams had significantly lower risks of pneumonia-related death, compared to those with lower (<11 g) or higher (>24 g) cumulative doses. Specifically, those in the 11–24 g range had a 30-day adjusted hazard ratio (aHR) of 0.33 and a 90-day aHR of 0.37, suggesting a protective effect within this dosage window.
The findings also indicate that CMD’s impact on pneumonia mortality is more pronounced in CAP cases compared to hospital-acquired pneumonia, highlighting the need for tailored corticosteroid management strategies depending on the type of pneumonia.
These results underscore the importance of cautious corticosteroid dosing in CTD patients, balancing the therapeutic benefits against the heightened risk of infection. Further research is needed to refine dosing guidelines, with a focus on reducing mortality risk in vulnerable CTD patients facing pneumonia.
Reference
Wang S et al. Association of cumulative methylprednisolone dosages with mortality risk from pneumonia in connective tissue disease patients. Sci Rep. 2024;DOI:10.1038/s41598-024-78233-5.
