Cosyntropin testing does not predict response to glucocorticoids in community-acquired pneumonia in a randomized controlled trial
Clinical Endocrinology Jan 15, 2019
Blum CA, et al. – In this study involving 326 prednisone-treated patients and 309 placebo-treated patients, researchers determined if cosyntropin testing can predict treatment response to glucocorticoids in community-acquired pneumonia (CAP). Study participants included hospitalized patients with CAP. The investigators performed 1-μg cosyntropin tests comparing prednisone 50 mg with placebo for 7 days. After low-dose cosyntropin testing at a dose of 1 μg, neither baseline nor stimulated cortisol predicted glucocorticoid responsiveness in mild-to-moderate CAP. No effect modifications were identified with respect to mortality, rehospitalization, antibiotic treatment, or CAP-related complications. Depending on cortisol values or cosyntropin test results, treatment decisions for or against adjunct glucocorticoids in CAP should not be taken.
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