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Comment & Response
June 2019

Future Directions for Corticosteroids in Treatment of Sepsis—Reply

Author Affiliations
  • 1West China Hospital, Sichuan University, Chengdu, Sichuan, China
JAMA Intern Med. 2019;179(6):845. doi:10.1001/jamainternmed.2019.0856

In Reply We are thankful for the interest shown by Spencer-Segal in our meta-analysis of corticosteroid use for treatment of sepsis.1 We welcome her thoughtful comments regarding additional directions for future trials.

First, Spencer-Segal pointed out the differences between the drugs regarding outcomes for corticosteroid use in patients with sepsis. We agree that not all corticosteroids are the same. A network meta-analysis2 concluded that methylprednisolone is less likely to result in shock reversal than hydrocortisone, though there is no clear evidence that any corticosteroid is better than another in reducing mortality.

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