MAGPIE
Trial question
What is the role of magnesium sulfate in patients with preeclampsia, and their babies?
Study design
Multi-center
Double blinded
RCT
Population
10141 female patients.
Inclusion criteria: female patients who had not given birth or were ≤ 24 hours postpartum with BP ≥ 140/90 mmHg and proteinuria ≥ 1+.
Key exclusion criteria: hypersensitivity to magnesium, hepatic coma with a risk of renal failure, or myasthenia gravis.
Interventions
N=5071 magnesium sulfate (5 g IV).
N=5070 placebo (10 mL normal saline).
Primary outcome
Eclampsia
0.8%
1.9%
1.9 %
1.4 %
0.9 %
0.5 %
0.0 %
Magnesium
sulfate
Placebo
Significant
decrease ▼
NNT = 90
Significant decrease in eclampsia (0.8% vs. 1.9%; RR 0.42, 95% CI 0.29 to 0.6).
Secondary outcomes
No significant difference in maternal death (0.2% vs. 0.4%; RR 0.55, 95% CI 0.26 to 1.14).
No significant difference in neonatal death (12.7% vs. 12.4%; RR 1.02, 99% CI 0.92 to 1.14).
Safety outcomes
Significant difference in side effects (24% vs. 5%).
Conclusion
In female patients who had not given birth or were ≤ 24 hours postpartum with BP ≥ 140/90 mmHg and proteinuria ≥ 1+, magnesium sulfate was superior to placebo with respect to eclampsia.
Reference
Altman D, Carroli G, Duley L et al. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002 Jun 1;359(9321):1877-90.
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