Sex-Based Differences in the Response to Dexamethasone in Bacterial Meningitis: Analysis of the European Dexamethasone in Adulthood Bacterial Meningitis Study

Dias, S; Brouwer, M; Beek, D

http://hdl.handle.net/10400.17/3862

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
BJCPharmacol.pdf		608.76 KB	Adobe PDF	Download

Send Feedback

Authors

Dias, S

Brouwer, M

Beek, D

Abstract(s)

Inflammatory markers have been found at higher concentrations in women than men with bacterial meningitis. To investigate sex-based differences in the response to dexamethasone, we performed a post hoc analysis of a double-blind, randomised multicentre trial of dexamethasone (10 mg, 4 times daily for 4 days) vs placebo in adults with bacterial meningitis. The primary outcome measure was the Glasgow outcome scale score at 8 weeks and interaction tests were used to examine subgroup differences. Between June 1993 and December 2001, 301 patients (56% male) were randomly assigned to a treatment group: 157 received dexamethasone and 144 placebo. Although dexamethasone reduced the risk of unfavourable outcome to a greater extent in women (relative risk [RR] 0.42, 95% confidence interval [CI] 0.21-0.86, P = .02) than men (RR 0.79, 95% CI 0.41-1.51, P = .55), on interaction testing (ratio of RR women:men 0.53, 95% CI 0.20-1.39, P = .19) patient sex was not a significant modifier of the effect of dexamethasone.

Keywords

CHLC NEU Adult Female Male Humans Biomarkers Dexamethasone Double-Blind Method Meningitis, Bacterial* / drug therapy Meningitis, Bacterial* / epidemiology