OBJECTIVES: Adjuvant @entity619 treatment in @entity1 with @entity497 ( @entity497 ) can reduce length of hospital stay. Whether there are subgroups of @entity1 that especially might benefit from @entity288 is unknown. We hypothesized that a discrepancy between systemic @entity32 and @entity701 level can define a subgroup that lacks a sufficient @entity701 response during @entity497 , and therefore particularly might benefit from corticosteroids. METHODS: A secondary analysis was performed on data from hospitalized @entity1 with @entity497 , randomized to a four-day course of @entity619 (5 mg daily) or placebo. Subgroups were made based on plasma cytokine levels ( @entity650 ( @entity650 ), @entity687 ( @entity687 ), @entity2842 ( @entity2842 )) and total plasma @entity701 on presentation. Intensive care unit (ICU) admission and mortality were assessed. RESULTS: 275 @entity1 (131 @entity619 , 144 placebo) were analyzed. In the subgroup of @entity1 (n = 23) with a high cytokine response ( @entity650 >=  92.5 pg/mL, @entity687 >=  14.8 pg/mL and @entity2842 >=  1154.5 pg/mL) and a discrepantly low @entity701 (lowest 50%), @entity619 treatment was associated with a significant decrease on a combined endpoint of mortality/ICU admission, as compared with placebo (0% vs. 43%, p < 0.01). In the subgroup of @entity1 with a high cytokine response and high @entity701 (n = 23), this favorable effect of @entity619 was absent (30% vs. 39%, p: 0.67). CONCLUSIONS: In @entity497 @entity1 presenting with a high pro-inflammatory cytokine response but a discrepantly low @entity701 , adjuvant @entity619 treatment was associated with a significant decrease in mortality/ICU admission.

Biomarkers define the clinical response to XXXX in @entity497 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity650 :: ('3569', 'Gene') :: ['IL-6', 'interleukin-6'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity2842 :: ('6347', 'Gene') :: ['monocyte chemotactic protein-1', 'MCP-1'] @entity497 :: ('MESH:D003147', 'Disease') :: ['CAP', 'community-acquired pneumonia'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity687 :: ('3576', 'Gene') :: ['interleukin-8', 'IL-8'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity619 :: (MESH:D003907,Chemical) :: ['dexamethasone']
