Sex differences in response to adjunctive corticosteroid treatment for patients with septic shock.

To determine sex differences in response to hydrocortisone treatment in patients with septic shock, we conducted a sex-disaggregated analysis of the ADRENAL trial. In men, but not in women, hydrocortisone treatment significantly decreased the time to ICU discharge (HR 0.85; 95% CI 0.76, 0.93 versus 0.95; 95% CI 0.85, 1.09) and liberation from mechanical ventilation (HR 0.84; 95% CI 0.76, 0.93 versus 0.97; 95% CI 0.86, 1.10), although the RHR were not significant ( I p i = 0.13, I p i = 0.06, respectively). This raises important considerations for interpretation of results, where women and men may be more or less likely to acquire severe forms of disease and where treatment effects are dependent on disease severity, true effects in women and men may be masked if sex-disaggregated analyses are not performed in the appropriate subgroups. [Extracted from the article]