How Long Should we Give Steroids for Patients With Severe PCP

The HOW LONG trial is an international, multicenter, Phase IV randomized clinical trial evaluating the optimal duration of adjunctive systemic corticosteroids in immunocompromised adults with severe Pneumocystis jirovecii pneumonia (PCP) who demonstrate early clinical recovery. Participants who no longer require supplemental oxygen by day 10 of corticosteroid therapy are randomized to discontinue corticosteroids at day 10 (or hospital discharge, if earlier) versus continue corticosteroids for a total of 21 days. The trial assesses whether earlier discontinuation reduces steroid-related complications while maintaining clinical outcomes.

NCT Number	NCT07328984
Lead Sponsor	McGill University Health Centre/Research Institute of the McGill University Health Centre
Conditions	Pneumocystis Pneumonia, Pneumocystis, Pneumocystis Jirovecii Infection, Pneumocystis Jiroveci Pneumonia, Pneumocystis Carinii; Infection, Resulting From HIV Disease, Pneumocystosis Associated With AIDS, Pneumocystosis; Pneumonia (Etiology)
Enrollment	416 participants
Start Date	2026-01-30
Primary Completion	2029-03-31 (estimated)
Study Completion	2029-06 (estimated)
Updated on ClinicalTrials.gov	2026-01-09