Popiela 1989.

Study characteristics
Methods	Randomised, prospective, double‐blind, placebo‐controlled, multi‐site clinical trial Study duration: 8 weeks
Participants	173 female participants (85 intervention, 88 control) with advanced, terminal cancer and symptoms (pain, debility, nausea, cachexia etc)
Interventions	Intervention: 125 mg infusion of methylprednisolone sodium succinate (MPSS) IV Control: matching placebo (P) Both for 56 consecutive days
Outcomes	Linear Analogue Self‐Assessment scale (LASA), patient ratings for pain, appetite, sense of well‐being completed weekly x 8 weeks Mortality Concomitant medications Adverse events
Notes	No significant changes with time for pain or sleep No significant changes in opioid use Better overall LASA score for patients on MPSS
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation specified by a computer‐generated randomisation scheme
Allocation concealment (selection bias)	Low risk	Double‐blind Study medication was provided in blinded packages containing vials of either placebo or MPSS
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Double‐blind, data from 2 sites removed ("significant investigator interaction")
Incomplete outcome data (attrition bias) All outcomes	Low risk	38% MPSS and 30% P died before study completion ITT analysis
Selective reporting (reporting bias)	Low risk	All outcomes reported
Other bias	Unclear risk	Sample size: 173 participants; 50 to 199 participants per treatment arm