On 2014 Aug 12, Karim Asehnoune commented:

In the CRASH trial, mild to severe TBI patients (GCS<14) were included, and a short course of high-dose methlyprednisolone was used. In the CORTI-TC study, only severe TBI patients (GCS<8 and abnormalities on brain CT-scan) were included, and low dose of steroids (hydrocortisone)+fludrocortisone were used. When comparing these 2 studies, one could say: the population is different, the drugs used are different, the outcomes are different. One book is closed, the other one remains open.

On 2014 Aug 10, Ryan Radecki commented:

Post-publication commentary:

"A Moratorium on Steroids for TBI"

In 2004 the CRASH trial examining the efficacy of steroids for acute traumatic brain injury (TBI) was published in The Lancet. This massive trial included over 10,000 patients was stopped prematurely because of an increased mortality in the patients who received corticosteroids. This should have definitively closed the book on such a therapy. Despite this damning evidence, it appears all one has to do to make this question relevant again is to devise a disease-oriented endpoint with plausible clinical relevance and test it using a sample size too small to differentiate these harms from the surrounding noise of statistical chance.

http://www.emlitofnote.com/2014/08/a-moratorium-on-steroids-for-tbi.html

On 2014 Aug 10, Ryan Radecki commented:

Post-publication commentary:

"A Moratorium on Steroids for TBI"

In 2004 the CRASH trial examining the efficacy of steroids for acute traumatic brain injury (TBI) was published in The Lancet. This massive trial included over 10,000 patients was stopped prematurely because of an increased mortality in the patients who received corticosteroids. This should have definitively closed the book on such a therapy. Despite this damning evidence, it appears all one has to do to make this question relevant again is to devise a disease-oriented endpoint with plausible clinical relevance and test it using a sample size too small to differentiate these harms from the surrounding noise of statistical chance.

http://www.emlitofnote.com/2014/08/a-moratorium-on-steroids-for-tbi.html

On 2014 Aug 12, Karim Asehnoune commented:

In the CRASH trial, mild to severe TBI patients (GCS<14) were included, and a short course of high-dose methlyprednisolone was used. In the CORTI-TC study, only severe TBI patients (GCS<8 and abnormalities on brain CT-scan) were included, and low dose of steroids (hydrocortisone)+fludrocortisone were used. When comparing these 2 studies, one could say: the population is different, the drugs used are different, the outcomes are different. One book is closed, the other one remains open.