Steroids and spinal cord injury: revisiting the NASCIS 2 and NASCIS 3 trials.
The National Acute Spinal Cord Injury Study (NASCIS) 2 and 3 trials are often cited as evidence that high-dose methylprednisolone is an efficacious intervention in the management of acute spinal cord injury. Neither of these studies convincingly demonstrate the benefit of steroids. There are concerns about the statistical analysis, randomization, and clinical end points. Even if the putative gains are statistically valid, the clinical benefits are questionable. Furthermore, the benefits of this intervention may not warrant the possible risks. This paper comments on these two clinical trials.
Nesathurai
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Boston University School of Medicine and New England Regional Spinal Cord Center, Boston Medical Center, Massachusetts 02118-2393, USA.
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D011597:Psychomotor Performance / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design; D013119:Spinal Cord Injuries / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone