Randomised trial of corticosteroids in the treatment of tuberculous pleurisy.
BACKGROUND
Tuberculous pleurisy can result in pleural fibrosis, calcification and thickening. To prevent these complications, corticosteroids are frequently used in addition to antituberculous drugs; however, new therapeutic regimens can control the disease and minimise the sequelae, and there is no convincing evidence of the benefit of the use of corticosteroids as adjuvant therapy.


METHODS
Patients received isoniazid 5 mg/kg and rifampicin 10 mg/kg daily for six months. Additionally, they were randomly assigned to a double blind treatment with either prednisone (1 mg/kg/day for 15 days and then tapering off) or placebo during the first month of treatment. Different clinical, radiological, and functional parameters were evaluated to assess the effect of corticosteroids.


RESULTS
Fifty seven patients received prednisone and 60 placebo. At the end of the treatment the clinical outcome, the rate of reabsorption of the pleural fluid, the pleural sequelae, as well as lung capacity were similar in both groups.


CONCLUSIONS
Corticosteroids do not influence the clinical outcome or the development of long term pleural sequelae in tuberculous pleurisy.
Galarza
I
I
Servei de Pneumologia, Hospital Universitari de Bellvitge, Barcelona, Spain.
Cañete
C
C
Granados
A
A
Estopà
R
R
Manresa
F
F
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use*; D011446:Prospective Studies; D012293:Rifampin / Q000627:therapeutic use; D017211:Treatment Failure; D014396:Tuberculosis, Pleural / Q000188:drug therapy*
D000995:Antitubercular Agents; D005938:Glucocorticoids; D011239:Prednisolone; D007538:Isoniazid; D012293:Rifampin