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Identifying an Optimal Corticosteroid Dosage Regimen for Acute Respiratory Distress Syndrome
Sponsor: National Taiwan University Hospital
Summary
The early phase of Acute Respiratory Distress Syndrome (ARDS) is characterized by intense alveolar inflammation. Corticosteroids have been used to treat ARDS for decades. Although their efficacy has been a subject of ongoing controversy, recent clinical practice guidelines for ARDS issued a weak recommendation in favor of corticosteroid use in early ARDS. However, the optimal dose and duration of corticosteroid therapy remain unclear. Low-dose, short-course regimens have been evaluated in clinical trials for severe pneumonia and COVID-19. However, no head-to-head comparisons have been conducted to evaluate the efficacy of prolonged versus short courses of corticosteroid therapy in ARDS. To address this gap, the investigators designed a 3×2 factorial trial to assess corticosteroid therapy for ARDS, aiming to evaluate the effects of different doses (no steroid, medium-low dose, and medium dose) and durations (prolonged vs. short) on clinical outcomes. In addition, the investigators will measure changes in inflammatory biomarkers for post hoc analysis to explore whether these biomarkers could guide the selection of steroid regimens.
Official title: Corticosteroids for Acute Respiratory Distress Syndrome: A Proof-of-Concept Trial Exploring Biological Heterogeneity and Treatment Response
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
300
Start Date
2025-06-15
Completion Date
2030-06-30
Last Updated
2026-07-17
Healthy Volunteers
No
Interventions
No steroids (Arm A)
Standard care for ARDS without corticosteroids.
Corticosteroids, low dose for 10 days
Dexamethasone: low dose for 10 days
Corticosteroids, low dose for 7 days
Dexamethasone: low dose for 7 days
Corticosteroids, medium dose for 10 days
Dexamethasone: medium dose for 10 days
Corticosteroids, medium dose for 7 days
Dexamethasone: medium dose for 7 days
No steroids (Arm B)
Standard care for ARDS without corticosteroids.
Locations (1)
National Taiwan University Hospital
Taipei, Taiwan