Core Highlights
The DexEnceph trial provides critical evidence regarding the use of corticosteroids in the management of Herpes Simplex Virus (HSV) encephalitis. The key takeaways from this multicentre, randomised, phase 3 trial include:
- Adjunct dexamethasone did not significantly improve verbal memory scores at 26 weeks compared to aciclovir alone.
- The safety profile of dexamethasone in this population was satisfactory, with no significant difference in serious adverse events between the treatment and control groups.
- The median time to initiate dexamethasone was 7 days after hospital admission, which may have limited its potential impact on early inflammatory damage.
- Early use of corticosteroids in suspected encephalitis appears unlikely to be harmful, supporting their use in cases where other inflammatory aetiologies are suspected alongside HSV.
