Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke: The MARVEL Randomized Clinical Trial
RCT (n=1680) found methylprednisolone added to endovascular treatment for large-vessel occlusion acute ischemic stroke did not improve disability level at 90 days (median modified Rankin Scale score of 3 in both groups (OR 1.10 [95% CI 0.96-1.25] for lower level of disability).
Source:
Journal of the American Medical Association
SPS commentary:
A related editorial notes that although there was no statistically significant benefit on the primary endpoint, the effect estimate favoured the corticosteroid group. The secondary outcome results suggest any potential benefit from corticosteroids was driven by a lower mortality rate (23.2% vs 28.5%, respectively; adjusted risk ratio 0.84 [95% CI 0.71-0.98]) combined with a shift toward moderate disability, with a higher proportion of patients who survived with moderate disability according to the modified Rankin Scale score at 3 months (aRR 1.07 [95% CI 1.00-1.14]).