{"id":11813,"date":"2025-11-17T19:39:10","date_gmt":"2025-11-17T18:39:10","guid":{"rendered":"https:\/\/rvh-synergie.org\/actualites\/les-steroides-intratracheaux-ne-presentent-aucun-avantage\/"},"modified":"2025-11-17T19:39:14","modified_gmt":"2025-11-17T18:39:14","slug":"les-steroides-intratracheaux-ne-presentent-aucun-avantage","status":"publish","type":"post","link":"https:\/\/rvh-synergie.org\/actualites\/les-steroides-intratracheaux-ne-presentent-aucun-avantage\/","title":{"rendered":"Les st\u00e9ro\u00efdes intratrach\u00e9aux ne pr\u00e9sentent aucun avantage"},"content":{"rendered":"
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Un essai clinique multicentrique a r\u00e9v\u00e9l\u00e9 que les st\u00e9ro\u00efdes intratrach\u00e9aux ne r\u00e9duisent pas le risque de maladie pulmonaire ou de d\u00e9c\u00e8s chez les nourrissons extr\u00eamement pr\u00e9matur\u00e9s, selon une \u00e9tude publi\u00e9e dans JAMA<\/i>.<\/p>\n

Les r\u00e9sultats remettent en question les conclusions ant\u00e9rieures d’\u00e9tudes plus petites dans lesquelles les chercheurs ont ajout\u00e9 le bud\u00e9sonide, un m\u00e9dicament anti-inflammatoire, au traitement par tensioactif standard actuel dans l’espoir de r\u00e9duire le risque de maladie pulmonaire chronique ou de d\u00e9c\u00e8s chez les nourrissons extr\u00eamement pr\u00e9matur\u00e9s, a d\u00e9clar\u00e9 Marta Perez, MD, professeur adjoint de p\u00e9diatrie \u00e0 la division de n\u00e9onatalogie, qui \u00e9tait co-auteur de l’\u00e9tude.<\/p>\n

\u00ab\u00a0La dysplasie broncho-pulmonaire (DBP), une insuffisance respiratoire chronique \u00e0 long terme, est l’une des s\u00e9quelles de pr\u00e9maturit\u00e9 les plus courantes que nous observons\u00a0\u00bb, a d\u00e9clar\u00e9 Perez. \u00ab\u00a0Malgr\u00e9 les progr\u00e8s des soins n\u00e9onatals, les taux de trouble borderline restent \u00e9lev\u00e9s.\u00a0\u00bb<\/p>\n

D\u00e9tails de l\u2019\u00e9tude et principales conclusions<\/h2>\n

L’\u00e9tude, dirig\u00e9e par le r\u00e9seau de recherche n\u00e9onatale de l’Institut national de la sant\u00e9 infantile et du d\u00e9veloppement humain, a port\u00e9 sur 641 nourrissons n\u00e9s entre 22 et 28 semaines de gestation ou pesant entre 401 et 1 000 grammes. Tous les participants ont re\u00e7u un traitement par surfactant dans les 50 heures suivant la naissance, la moiti\u00e9 d’entre eux ayant \u00e9t\u00e9 randomis\u00e9s pour recevoir \u00e9galement une dose suppl\u00e9mentaire de bud\u00e9sonide.<\/p>\n

Malgr\u00e9 l’espoir que la th\u00e9rapie combin\u00e9e pourrait am\u00e9liorer les r\u00e9sultats, l’essai a \u00e9t\u00e9 interrompu pr\u00e9matur\u00e9ment apr\u00e8s qu’une analyse interm\u00e9diaire n’ait montr\u00e9 aucun b\u00e9n\u00e9fice significatif. L’incidence de dysplasie bronchopulmonaire ou de d\u00e9c\u00e8s \u00e0 l’\u00e2ge de 36 semaines \u00e9tait presque identique entre les deux groupes\u00a0: 68,5\u00a0% dans le groupe bud\u00e9sonide-surfactant contre 67,9\u00a0% dans le groupe surfactant uniquement.<\/p>\n

Comparaisons avec les recherches pr\u00e9c\u00e9dentes et prochaines \u00e9tapes<\/h2>\n

Les r\u00e9sultats contrastent avec des essais ant\u00e9rieurs plus petits qui avaient sugg\u00e9r\u00e9 un avantage potentiel de combiner le bud\u00e9sonide avec un surfactant, une th\u00e9rapie standard dans laquelle la substance est administr\u00e9e pour tapisser les sacs a\u00e9riens dans les poumons et aider \u00e0 les emp\u00eacher de s’effondrer. Cependant, ces \u00e9tudes n\u2019avaient pas l\u2019ampleur et la rigueur de l\u2019essai multicentrique le plus r\u00e9cent, selon les auteurs.<\/p>\n

\u00c0 l\u2019avenir, Perez et ses collaborateurs visent \u00e0 \u00e9tudier si les st\u00e9ro\u00efdes intratrach\u00e9aux peuvent aider les b\u00e9b\u00e9s pr\u00e9matur\u00e9s souffrant d\u2019inflammation ou pr\u00e9sentant certaines pr\u00e9dispositions g\u00e9n\u00e9tiques, a-t-elle d\u00e9clar\u00e9.<\/p>\n

\u00ab\u00a0Nous ne savons toujours pas si adapter cette approche aux enfants pr\u00e9sentant certains facteurs pr\u00e9disposants, tels qu’un degr\u00e9 \u00e9lev\u00e9 d’inflammation des poumons ou ceux qui ont souffert d’une inflammation pr\u00e9natale importante, pourrait la rendre plus utile\u00a0\u00bb, a d\u00e9clar\u00e9 Perez.<\/p>\n

D\u00e9fis persistants dans le traitement du trouble borderline<\/h2>\n

Le trouble borderline reste l\u2019une des principales causes de complications respiratoires et d\u00e9veloppementales \u00e0 long terme chez les pr\u00e9matur\u00e9s. Bien que le traitement par surfactant soit la pierre angulaire des soins n\u00e9onatals, Perez a d\u00e9clar\u00e9 que les enqu\u00eateurs continuent de rechercher des traitements susceptibles de r\u00e9duire davantage le risque de cette maladie pulmonaire chronique.<\/p>\n

\u00ab\u00a0Bien que nous ayons eu la chance en n\u00e9onatalogie de disposer de nombreuses donn\u00e9es issues d’essais contr\u00f4l\u00e9s randomis\u00e9s \u00e0 grande \u00e9chelle, nous avons encore de nombreuses questions cliniques et il existe beaucoup d’incertitude sur les moyens de traiter les b\u00e9b\u00e9s pr\u00e9matur\u00e9s et sur la mani\u00e8re dont nous pourrions adapter nos approches th\u00e9rapeutiques\u00a0\u00bb, a d\u00e9clar\u00e9 Perez. \u00ab\u00a0Notre travail doit donc continuer.\u00a0\u00bb<\/p>\n

<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"

Un essai clinique multicentrique a r\u00e9v\u00e9l\u00e9 que les st\u00e9ro\u00efdes intratrach\u00e9aux ne r\u00e9duisent pas le risque<\/p>\n","protected":false},"author":1,"featured_media":11814,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[86],"tags":[1441,5538,7729,49,104,80],"class_list":["post-11813","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-les-maladies","tag-aucun","tag-avantage","tag-intratracheaux","tag-les","tag-presentent","tag-steroides","generate-columns","tablet-grid-50","mobile-grid-100","grid-parent","grid-50","resize-featured-image"],"yoast_head":"\nLes st\u00e9ro\u00efdes intratrach\u00e9aux ne pr\u00e9sentent aucun avantage - RVH-Synergie.org<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/rvh-synergie.org\/actualites\/les-steroides-intratracheaux-ne-presentent-aucun-avantage\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les st\u00e9ro\u00efdes intratrach\u00e9aux ne pr\u00e9sentent aucun avantage - 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