{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:56:16Z","timestamp":1787990176696,"version":"build-2784847793"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Northern Health Foundation"},{"name":"Sir Charles Gairdner Hospital Research Advisory Committee"},{"name":"Northern Health Foundation"},{"name":"Sir Charles Gairdner Hospital Research Advisory Committee"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Pleural effusion commonly complicates community-acquired pneumonia and is associated with intense pleural inflammation. Whether antiinflammatory treatment with corticosteroids improves outcomes is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the effects of corticosteroids in an adult population with pneumonia-related pleural effusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The STOPPE (Steroid Therapy and Outcome of Parapneumonic Pleural Effusions) trial was a pilot, multicenter, double-blinded, placebo-controlled, randomized trial involving six Australian centers. Patients with community-acquired pneumonia and pleural effusion were randomized (2:1) to intravenous dexamethasone (4 mg twice daily for 48 h) or placebo and followed for 30 days. Given the diverse effects of corticosteroids, a comprehensive range of clinical, serological, and imaging outcomes were assessed in this pilot trial (ACTRN12618000947202).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Eighty patients were randomized (one withdrawn before treatment) and received dexamethasone (n\u2009=\u200951) or placebo (n\u2009=\u200928). This pilot trial found no preliminary evidence of benefits of dexamethasone in improving time to sustained (&amp;gt;12 h) normalization of vital signs (temperature, oxygen saturations, blood pressure, heart, and respiratory rates): median, 41.0 (95% confidence interval, 32.3\u201354.5) versus 27.8 (15.4\u201349.5) hours in the placebo arm (hazard ratio, 0.729 [95% confidence interval, 0.453\u20131.173]; P\u2009=\u20090.193). Similarly, no differences in C-reactive protein or leukocyte counts were observed, except for a higher leukocyte count in the dexamethasone group at Day 3. Pleural drainage procedures were performed in 49.0% of dexamethasone-treated and 42.9% of placebo-treated patients (P\u2009=\u20090.60). Radiographic pleural opacification decreased over time with no consistent intergroup differences. Mean duration of antibiotic therapy (22.4 [SD, 15.4] vs. 20.4 [SD, 13.8] d) and median hospitalization (6.0 [interquartile range, 5.0\u201310.0] vs. 5.5 [interquartile range, 5.0\u20138.0] d) were similar between the dexamethasone and placebo groups. Serious adverse events occurred in 25.5% of dexamethasone-treated and 21.4% of placebo-treated patients. Transient hyperglycemia more commonly affected the dexamethasone group (15.6% vs. 7.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systemic corticosteroids showed no preliminary benefits in adults with parapneumonic effusions.<\/jats:p>\n                    <jats:p>Clinical trial registered with www.anzctr.org.au (ACTRN12618000947202).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202107-1600oc","type":"journal-article","created":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T14:24:26Z","timestamp":1643207066000},"page":"1093-1101","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":23,"title":["Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): A Pilot Randomized Clinical Trial"],"prefix":"10.1093","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8668-1788","authenticated-orcid":false,"given":"Deirdre B.","family":"Fitzgerald","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"},{"name":"Medical School, Faculty of Health and Medical Sciences"},{"name":"Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant W.","family":"Waterer","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health and Medical Sciences"},{"name":"Department of Respiratory Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charley","family":"Budgeon","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjan","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward T.","family":"Fysh","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health and Medical Sciences"},{"name":"Department of Respiratory Medicine, St. John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0943-4297","authenticated-orcid":false,"given":"Sanjeevan","family":"Muruganandan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Stanley","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tajalli","family":"Saghaie","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia"},{"name":"Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Badiei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"},{"name":"Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia"},{"name":"School of Medical and Health Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilman","family":"Harryanto","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Northern Health, Epping, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maree","family":"Azzopardi","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Manners","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, St. John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norris S. 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