BEGIN:VCALENDAR VERSION:2.0 PRODID:-//wp-events-plugin.com//7.4.0.1//EN TZID:Europe/Paris X-WR-TIMEZONE:Europe/Paris BEGIN:VEVENT UID:356@isdm.umontpellier.fr DTSTART;TZID=Europe/Paris:20250414T140000 DTEND;TZID=Europe/Paris:20250414T140000 DTSTAMP:20260828T093900Z URL:https://isdm.umontpellier.fr/events/predicting-benefit-from-adjuvant-t herapy-with-corticosteroids-in-community-acquired-pneumonia-a-data-driven- analysis-of-randomised-trials-3/ SUMMARY:Predicting benefit from adjuvant therapy with corticosteroids in co mmunity-acquired pneumonia: a data-driven analysis of randomised trials DESCRIPTION:Online\n\nMachine Learning in Montpellier\, Theory &\; Pract ice - Jim Smit (Erasmus Medical Center\, Rotterdam)\n\nBackground Despite several randomised controlled trials (RCTs) on the use of adjuvant treatme nt with corticosteroids in patients with community-acquired pneumonia (CAP )\, the effect of this intervention on mortality remains controversial. We aimed to evaluate heterogeneity of treatment effect (HTE) of adjuvant tre atment with corticosteroids on 30-day mortality in patients with CAP. Meth ods In this individual patient data meta-analysis\, we included RCTs publi shed before July 1\, 2024\, comparing adjuvant treatment with corticostero ids versus placebo in patients hospitalised with CAP. The primary endpoint was 30-day all-cause mortality\, collected across all trials\, and analys es followed the intention-to-treat principle. We analysed HTE using risk a nd effect modelling. For risk modelling\, patients were classified as havi ng less severe or severe CAP based on the pneumonia severity index (PSI)\, comparing PSI class I–III versus class IV–V. For effect modelling\, w e trained a corticosteroid-effect model on six trials and externally valid ated it using data from two trials\, received after model preregistration. This model classified patients into two groups: no predicted benefit and predicted benefit from adjuvant treatment with corticosteroids. The litera ture search was registered on PROSPERO\, CRD42022380746. Findings We inclu ded eight RCTs with 3224 patients. Across all eight trials\, 246 (7·6%) p atients died within 30 days (106 [6·6%] of 1618 in the corticosteroid gro up vs 140 [8·7%] of 1606 in the placebo group\; odds ratio [OR] 0·72 [95 % CI 0·56–0·94]\, p=0·017). The corticosteroid-effect model\, which s elected C-reactive protein (CRP)\, showed significant HTE during external validation in the two most recent trials. In these trials\, 154 (11·4%) o f 1355 patients died within 30 days (88 [13·1%] of 671 in the placebo gro up vs 66 [9·6%] of 684 in the corticosteroid group\; OR 0·71 [95% CI 0· 50–0·99]\, p=0·044). Among patients predicted to have no benefit (CRP ≤204 mg/L\, nr5)\, no significant effect was observed (OR 0·98 [95% CI 0·63–1·50])\, whereas for those with predicted benefit (CRP >\;204 m g/L\, nc0)\, 39 (13·0%) of 301 patients died in the placebo group compare d with 20 (6·1%) of 329 in the corticosteroid group (0·43 [0·25–0·76 ]\, pinteraction=0·026). No significant HTE was found between less severe CAP (PSI class I–III\, n"\;9) and severe CAP (PSI class IV–V\, n2 6). Corticosteroid therapy significantly increased hyperglycaemia risk (44 [12·8%] of 344 in the placebo group vs 84 [24·8%] of 339 in the cortico steroid group\; OR 2·50 [95% CI 1·63–3·83]\, p<\;0·0001) and hospi tal re-admission risk (30 [3·7%] of 814 in the placebo group vs 57 [7·0% ] of 819 in the corticosteroid group\; 1·95 [1·24–3·07]\, p=0·0038). Interpretation Overall\, adjuvant therapy with corticosteroids significan tly reduces 30-day mortality in patients hospitalised with CAP. The treatm ent effect varied significantly among subgroups based on CRP concentration s\, with a substantial mortality reduction observed only in patients with high baseline CRP. Full text: https://isdm.umontpellier.fr/authors.elsevie r.com/a/1kWkq7tFB1XhtL"\;\n\nMachine Learning in Montpellier\, Theory &\; Practice ATTACH;FMTTYPE=image/jpeg:https://isdm.umontpellier.fr/wp-content/uploads/ 2026/06/ml-mtp-gC78d5.png CATEGORIES:ML MTP END:VEVENT BEGIN:VTIMEZONE TZID:Europe/Paris X-LIC-LOCATION:Europe/Paris BEGIN:DAYLIGHT DTSTART:20250330T030000 TZOFFSETFROM:+0100 TZOFFSETTO:+0200 TZNAME:CEST END:DAYLIGHT END:VTIMEZONE END:VCALENDAR