Acute unilateral vestibulopathy and corticosteroid treatment - A randomized placebo-controlled double-blind trial
Sjögren, Julia LU
; Fransson, Per-Anders
LU
; Magnusson, Måns
LU
; Karlberg, Mikael
LU
and Tjernström, Fredrik
LU
(2025)
In Journal of vestibular research : equilibrium & orientation
35(2).
p.91-101
- Abstract
BACKGROUND: The efficacy of corticosteroids for treating acute vestibular neuritis, or acute unilateral vestibulopathy (AUVP), remains controversial.
OBJECTIVE: This study aimed to evaluate whether corticosteroids improve vestibular function and reduce symptoms in both acute and chronic phases of AUVP.
METHODS: This randomized, placebo-controlled, double-blind trial included patients with AUVP (ages 18-80) from emergency departments at three sites in southern Sweden. Patients were randomly assigned to one of three groups: placebo, 3-day or 10-day corticosteroid treatment. The steroid groups received intravenous betamethasone followed by oral steroids, while the placebo group received intravenous saline followed by oral... (More)
BACKGROUND: The efficacy of corticosteroids for treating acute vestibular neuritis, or acute unilateral vestibulopathy (AUVP), remains controversial.
OBJECTIVE: This study aimed to evaluate whether corticosteroids improve vestibular function and reduce symptoms in both acute and chronic phases of AUVP.
METHODS: This randomized, placebo-controlled, double-blind trial included patients with AUVP (ages 18-80) from emergency departments at three sites in southern Sweden. Patients were randomly assigned to one of three groups: placebo, 3-day or 10-day corticosteroid treatment. The steroid groups received intravenous betamethasone followed by oral steroids, while the placebo group received intravenous saline followed by oral placebo. The primary outcome was canal paresis (%) after 12 months, measured via caloric testing. Secondary outcomes included vHIT gain, Diary Vertigo score, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale. Analyses were conducted on an intention-to-treat basis. The trial was registered with the EU Clinical Trials Register (EudraCT Number: 2014-005484-32) and ClinicalTrials.gov (NCT00802529).
RESULTS: From December 2015 to March 2021, 350 patients were screened, and 69 were included: 23 in the 10-day corticosteroid group, 22 in the 3-day corticosteroid group, and 24 in the placebo group. All groups showed significant improvement in caloric function over time ( p = .002), with no significant differences between groups at any time point ( p = .629). Change in caloric asymmetry from baseline to 12 months did not differ between the treatment groups and the placebo group: mean difference -8.34 (95% CI -25.93 to 9.26; p = .347) in the 10-day steroid group and -6.61 (-24.67 to 11.45; p = .467) in the 3-day steroid group, compared with placebo. Secondary outcomes showed no significant differences between groups. Corticosteroid treatments were well tolerated with no safety concerns.
CONCLUSIONS: Corticosteroid treatment does not significantly improve caloric recovery, vHIT gain recovery, or subjective well-being in patients with AUVP.
(Less)
- author
- Sjögren, Julia
LU
; Fransson, Per-Anders
LU
; Magnusson, Måns
LU
; Karlberg, Mikael
LU
and Tjernström, Fredrik
LU
- organization
- publishing date
- 2025-03-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute unilateral vestibulopathy, corticosteroid treatment, randomized placebo-controlled trail, steroid treatment, vestibular neuritis
- in
- Journal of vestibular research : equilibrium & orientation
- volume
- 35
- issue
- 2
- pages
- 11 pages
- publisher
- IOS Press
- external identifiers
-
- pmid:39973595
- scopus:105002734581
- pmid:39973595
- ISSN
- 1878-6464
- DOI
- 10.1177/09574271241307649
- language
- English
- LU publication?
- yes
- id
- af210531-68b4-4ba2-98dc-8956e5f82e20
- date added to LUP
- 2025-03-13 15:17:57
- date last changed
- 2025-05-08 08:12:58
@article{af210531-68b4-4ba2-98dc-8956e5f82e20,
abstract = {{<p>BACKGROUND: The efficacy of corticosteroids for treating acute vestibular neuritis, or acute unilateral vestibulopathy (AUVP), remains controversial.</p><p>OBJECTIVE: This study aimed to evaluate whether corticosteroids improve vestibular function and reduce symptoms in both acute and chronic phases of AUVP.</p><p>METHODS: This randomized, placebo-controlled, double-blind trial included patients with AUVP (ages 18-80) from emergency departments at three sites in southern Sweden. Patients were randomly assigned to one of three groups: placebo, 3-day or 10-day corticosteroid treatment. The steroid groups received intravenous betamethasone followed by oral steroids, while the placebo group received intravenous saline followed by oral placebo. The primary outcome was canal paresis (%) after 12 months, measured via caloric testing. Secondary outcomes included vHIT gain, Diary Vertigo score, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale. Analyses were conducted on an intention-to-treat basis. The trial was registered with the EU Clinical Trials Register (EudraCT Number: 2014-005484-32) and ClinicalTrials.gov (NCT00802529).</p><p>RESULTS: From December 2015 to March 2021, 350 patients were screened, and 69 were included: 23 in the 10-day corticosteroid group, 22 in the 3-day corticosteroid group, and 24 in the placebo group. All groups showed significant improvement in caloric function over time ( p = .002), with no significant differences between groups at any time point ( p = .629). Change in caloric asymmetry from baseline to 12 months did not differ between the treatment groups and the placebo group: mean difference -8.34 (95% CI -25.93 to 9.26; p = .347) in the 10-day steroid group and -6.61 (-24.67 to 11.45; p = .467) in the 3-day steroid group, compared with placebo. Secondary outcomes showed no significant differences between groups. Corticosteroid treatments were well tolerated with no safety concerns. </p><p>CONCLUSIONS: Corticosteroid treatment does not significantly improve caloric recovery, vHIT gain recovery, or subjective well-being in patients with AUVP.</p>}},
author = {{Sjögren, Julia and Fransson, Per-Anders and Magnusson, Måns and Karlberg, Mikael and Tjernström, Fredrik}},
issn = {{1878-6464}},
keywords = {{acute unilateral vestibulopathy; corticosteroid treatment; randomized placebo-controlled trail; steroid treatment; vestibular neuritis}},
language = {{eng}},
month = {{03}},
number = {{2}},
pages = {{91--101}},
publisher = {{IOS Press}},
series = {{Journal of vestibular research : equilibrium & orientation}},
title = {{Acute unilateral vestibulopathy and corticosteroid treatment - A randomized placebo-controlled double-blind trial}},
url = {{http://dx.doi.org/10.1177/09574271241307649}},
doi = {{10.1177/09574271241307649}},
volume = {{35}},
year = {{2025}},
}