Fluticasone propionate (Flonase), a corticosteroid nasal spray, was found to be a better option than a combination of popular anti-allergy drugs loratidine (Claritin) and montelukast (Singulair) for managing seasonal allergies, according to a research.

Robert Naclerio, M.D., professor of surgery at the University of Chicago and director of the study, said patients afflicted with hay fever and treated with fluticasone propionate experienced significant improvement in terms of inflammation measures.

From News.Bio-Medicine.Org:

“Because of the effect on inflammation, we prefer fluticasone,” he added, “but for patients, the choice may come down to cost and whether they would prefer a pill or a spray.”

Since one out of five people in the United States suffers from seasonal allergies, such preferences have financial implications. Antihistamines are prescribed three times as often, even though intranasal corticosteroids are less expensive than the non-sedating antihistamines. Combining loratidine with montelukast increases the cost difference.

A daily dose of Claritin, the leading antihistamine, costs $2.92 at the University of Chicago Hospitals pharmacy. Singulair, which works by blocking leukotrienes — substances that trigger inflammation — costs $4 per day. Flonase, the leading prescription nasal spray, costs $2.21 per day.

The finding by researchers from University of Chicago was presented at the 58th annual meeting of the American Academy of Allergy, Asthma and Immunology.

According to the results of a study presented by University of Cincinnati (UC) transplantation researchers, post-transplant patients not using corticosteroids any more are better positioned than their counterparts on steroids.

These benefits include minimized early mortality, fewer cardiovascular events, and enhanced graft survival rates.

From Sciencedaily.com:

“Ten years ago, almost 80 percent of post-transplant kidney patients were discharged from the hospital on steroids,” she says. “Now, according to United Network for Organ Sharing (UNOS) reports, less than 20 percent are discharged from the hospital on steroids. We’ve effectively removed chronic steroids from the immunosuppressive regimen while maintaining similar graft survival outcomes.”

In work led by UC research assistant professor of surgery Adele Rike Shields, PharmD, researchers are now able to show patients removed from a steroid treatment have decreased cardiovascular events after transplant, in addition to their lowered side effects.

Shields evaluated acute graft rejection and graft loss in 630 kidney transplant patients withdrawn from corticosteroids. She found the risk factors in the corticosteroid-withdrawn kidney transplant population are similar to those traditionally defined under conventional immunosuppression with steroids.

Researchers with the division of transplantation and department of internal medicine presented the work at the American Transplant Congress (ATC), the annual meeting of the American Society of Transplantation, held May 1-5 in San Diego.

The frequency of exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD) may be reduced by as much as 35 percent with the use of a macrolide antibiotic in the long term, as per a London-based study.

It was remarked by lead author of the paper, Terence A. R. Seemungal, Ph.D., and Jadwiga Wedzicha, M.D., principle investigator that the study results suggest a significant impact of low-dose macrolide therapy, minimizing frequency of exacerbation, and severity with moderate to severe COPD.

From News-Medical.Net:

While their findings are encouraging, Dr. Seemungal points out that they must be put in context with future findings. Furthermore, the threat of growing antibiotic resistance resulting from widespread prophylactic use of erythromycin is not a trivial concern. “In this scenario, substantial, widespread emergence of macrolide bacterial resistance is virtually foreordained, with attendant reduction in the antimicrobial usefulness of this drug class,” wrote Ken M. Kunisaki, M.D. and Denise E. Niewoehner, M.D., of the Veterans Affairs Medical Center in Minneapolis, in the accompanying editorial. “Balancing benefit against harm could pose a dilemma for which there might be no clear answers.”

Moreover, not all of the study patients were treated with guideline-recommended therapy, such as inhaled corticosteroids or inhaled long-acting bronchodilators, which have been shown to decrease exacerbation frequency. The degree of added benefit of erythromycin over and above standard therapy will require further study.

“Observations that any intervention might decrease the frequency and severity of acute exacerbations in COPD present considerable public health implications,” observed John Heffner, M.D., past president of the ATS. “Exacerbations occur about once a year among patients with moderate to severe COPD and account for more than $30 billion dollars in direct and indirect costs annually in the United States alone.”

The results of this study were published in the first issue for December of the American Journal of Respiratory and Critical Care Medicine, which is published by the American Thoracic Society.

According to Lung disease experts at Johns Hopkins, medical practitioners must observe a high sense of care before recommending corticosteroids to patients suffering from COPD (chronic obstructive pulmonary disease).

It is believed that COPD is a complication affecting more than 11 million people in the United States alone and a big part of this affected population belongs to the category of past or present-day smokers.

From News-Medical.Net:

Despite the increased pneumonia risk, the team found no clear evidence that the drug therapy also pushes up rates for other steroid-related problems, such as bone fractures, nor was there an increase in deaths.

Senior study investigator and critical care specialist Eddy Fan, M.D., says the results of the analysis should not alarm patients or cause them to stop taking their medications but should spur physicians to screen and monitor their patients to find the lowest possible steroid dose that works, especially in the elderly, people with immune system problems, and people who have had multiple bouts of pneumonia and for whom repeat bacterial infection might be a life-threatening complication.

“Inhaled corticosteroids are not of equal benefit to all, and what we are seeing is that the treatment may be more harmful and pose a greater risk of harm to some,” says Fan, an instructor at the Johns Hopkins University School of Medicine.

Lead author and pulmonologist M. Brad Drummond, M.D., M.H.S., said the finding is nothing but a reminder for prevention of pneumonia, which can double the risk of death.

Patients suffering from chronic obstructive pulmonary disease (COPD) and administered with inhaled corticosteroids are at a lesser risk of mortality than COPD patients untreated with steroids.

This finding was noted in a new study that was published in an issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP).

The involved researchers noted that COPD patients on corticosteroids within 30 days from hospital discharge displayed a 25 percent reduced all-cause mortality rate and those using steroids paired with beta-agonists displayed a fall in cardiovascular-related deaths by 38 percent.

From News-Medical.Net:

Researchers also found a 23 percent reduced risk of death when comparing the effects of inhaled steroids with bronchodilators in patients in the 65+ group. In all cases, the most significant results were found when inhaled corticosteroids were administered within the first 30 days following hospital discharge.

“Our results indicate that the effect of inhaled corticosteroids is relatively short-term and that those currently using it are relatively better protected, ” said Dr. Macie. “Inhaled corticosteroids should be prescribed as soon as clinically indicated. By treating COPD with inhaled corticosteroids, we have the potential to reduce the effect and prolong life.”

“The findings from this study are intriguing for clinicians and point to the need for further research to define the role and mechanisms of the effect of inhaled corticosteroids on both cardiovascular and respiratory mortality,” said W. Michael Alberts, MD, FCCP, President of the ACCP.

Author Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada, remarked that COPD often remains an underrated lung ailment that has associated lung disease.

Steroids can prove to be an effective option with antibiotics when it comes to reducing recovery time associated with pneumonia, according to a study by researchers from the UT Southwestern Medical Center.

The study suggested that health of a patient suffering from pneumonia can be restored easily if steroids are administered in a combination with antibiotics as compared to the use of antibiotics alone.

From News-medical.net:

Adding corticosteroids to traditional antimicrobial therapy might help people with pneumonia recover more quickly than with antibiotics alone, UT Southwestern Medical Center scientists have found.

Unlike the anabolic steroids used to bulk up muscle, corticosteroids are often used to treat inflammation related to infectious diseases, such as bacterial meningitis. Used against other infectious diseases, however, steroid therapy has been shown to be ineffective or even harmful.

In a study available online and in a future issue of the Journal of Infectious Diseases, researchers at UT Southwestern show that mice infected with a type of severe bacterial pneumonia and subsequently treated with steroids and antibiotics recovered faster and had far less inflammation in their lungs than mice treated with antibiotics alone.

The study led by Dr. Robert Hardy, Study’s Senior Author & Associate Professor of Internal Medicine and Pediatrics, also suggested that steroids are good for treating inflammation of the lungs while antibiotics prove effective for killing the bug.

Pharmacists can considerably reduce worries of patients in relation to the use of steroids by as much as 50 percent through intervening to address patients’ concerns, as per a new research launched at the British Pharmaceutical Conference in Manchester.

The study, which was undertaken by Pharmacy Alliance, the Medicines Management Division of UniChem, investigated the inputs of community pharmacists in collaboration with general physicians for meeting the needs of patients with atomic eczema.

From News-Medical.Net:

The results showed that, following help and advice from a pharmacist, or pharmacy staff:

* Steroid concerns reduced from 68% to 30%

* Poor understanding of atopic eczema fell from 43% to 6%

* The need for lifestyle advice dropped from 51% to 20%

The research also found that:

Community pharmacists identified a total of 1,597 problems. Of these:

* 20% involved steroid concerns

* 15% required lifestyle advice

* 12% of patients had unmet treatment goals

* 11% of patients had poor understanding of atopic eczema

Pharmacist Caroline Tinkler who led the study remarked that it is important for the patients to be appropriately educated about eczema and treatment to derive optimum benefits and relief.

It was suggested that a pharmacist advice can relieve worries of patients who are about to use topical corticosteroids, to a great extent.

According to a new review of recently concluded studies comparing inhaled corticosteroids and the medicine cromolyn, asthmatic patients, including children and adults, can exercise a better control over their asthma and breathe deeper with inhaled corticosteroids.

James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues said that asthmatic patients treated with steroids have an advantage of scoring higher in lung function tests. It was also remarked by them that the usage of corticosteroids allow patients to make lesser use of inhalers than patients who makes use of cromolyn.

From News-Medical.Net:

“To our knowledge, this is the first systematic review comparing the effects of cromolyn to the gold standard, inhaled steroids,” Guevara said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The consensus still leaves room for cromolyn treatment, according to William Storms, M.D., an allergist at the University of Colorado Health Sciences Center and director of the William Storms Allergy Clinic in Colorado Springs.

“Any expert would agree that inhaled corticosteroids are preferred first-line therapy for treatment of persistent asthma, which requires daily therapy. But we also will agree with the NIH [National Institutes of Health] asthma guidelines, which state that cromolyn and other drugs are alternative therapies,” Storms said.

Cromolyn, or sodium cromoglycate, and inhaled corticosteroids both block the action of certain inflammatory cells in the lungs. Physicians recommend both types of medication for persistent asthma, but individual studies disagree about which type of medication works best, the reviewers found.

Guevara and colleagues said that inhaled corticosteroids are superior to cromolyn irrespective of asthma severity level and also said that the attained results are so decisive that there is no need for any future study on this matter.

The addition to corticosteroids to the traditional antimicrobial therapy can prove to be very effective in treating patients suffering from pneumonia than treating them with antibiotics alone, as per scientists from the UT Southwestern Medical Center.

Pneumonia is an infection of the lung, which is primarily characterized by breathing disorders and is spread by coughing and sneezing.

Dr. Robert Hardy, Associate Professor of Internal Medicine and Pediatrics and the study’s Senior Author remarked that steroids can prove their real worth when it comes to restoration of health after an individual catches pneumonia.

From News-Medical.Net:

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induced airway inflammation. The animals were then evaluated after one, three and six days of therapy.

“It turns out that the group that got both the antibiotic and the steroids did the best,” Dr. Hardy said. “The inflammation in their lungs got significantly better.”

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

It was also remarked by Dr. Hardy that though it is too early for him or others to recommend steroids as a form of standard treatment to patients with bacterial pneumonia but the findings do support the need for a clinical trial in the near future.

Researchers found that taking inhaled corticosteroids may lower the risk of lung cancer among people with chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids reduce inflammation in the airways thereby improving symptoms associated with the disease.

Previous studies have shown that inhaled corticosteroids reduce markers of inflammation such as C-reactive protein and reduce airway inflammation.

From Bio-Medicine:

The study conducted by the University of Washington suggests people who took at least 1,200 micrograms per day of inhaled corticosteroids had a 61% lower risk of developing lung cancer than non-users.

Researchers followed a group of more than 10,000 mostly older male U.S. veterans with COPD who were treated in Veterans Affairs primary care clinics from 1996 to 2001. Of these, 517 were regular users of inhaled corticosteroids as determined by records of pharmacy refills and were included in the study’s analysis.

The results, published in the American Journal of Respiratory and Critical Medicine, suggested that compared with non-users of corticosteroids, those who took 1,200 micrograms or more per day of inhaled corticosteroids were 61% less likely to develop lung cancer.

The researchers note that this is an observational study that “cannot conclude that [inhaled corticosteroids] reduce lung cancer” and that the results need confirmation. They also say no drugs have been clinically proven to prevent lung cancer among those at risk, but several are under investigation.

Researchers said inflammation in the lungs is thought to play an important role in both COPD and lung cancer, and the results suggest that daily use of inhaled corticosteroids may help fight inflammation and prevent the progression from COPD to lung cancer.

Smoking is a primary cause of COPD, which includes two inflammatory lung diseases that interfere with breathing: chronic bronchitis and emphysema. An estimated 11 million adults suffer from COPD which could lead to lung cancer.

An inflammatory condition known as Eosinophilic esophagitis (EE) mimics reflux and causes refusal to eat. This condition affects about 1 in 2000 children in the United States and the number of cases continuously to grow. Researchers from the Indiana University School of Medicine and Riley Hospital for Children report that treatment with oral or swallowed/sprayed steroids results in significant patient improvement, but if the treatment is stopped, symptoms relapse continues.

The study made by the team of Dr. Sandeep K. Gupta showed that oral, spray or systemic corticosteroids all provide significant improvement in the conditions of the patients. However, systemic corticosteroids showed faster effects and relief on the patients.

From Medical News Today:

The results of a randomized clinical trial which compared prednisone and another commonly prescribed medication appear in the February 2008 issue of Clinical Gastroenterology and Hepatology.

“We are seeing increasing numbers of children with EE who can benefit from effective therapy. Our study found that while systemic corticosteroids provided better initial patient improvement compared to swallowed steroids, long term results were similar between the groups,” said Sandeep K. Gupta, M.D., IU School of Medicine associate professor of clinical pediatrics and a Riley Hospital pediatric gastroenterologist.

“A child will often continue to suffer in silence if this disease is left untreated. We are not sure why the number of cases is increasing, but we are seeing an average of two new cases every week at Riley Hospital. As we study treatment options, we are also investigating how and why food allergies and environmental factors appear to play a role in this disease,” said Dr. Gupta.

EE can be a serious condition and cause children to refuse to eat, to vomit, or to get food stuck as the esophagus narrows from inflammation. Boys are twice more susceptible to develop Eosinophilic esophagitis than girls.

Inhaled corticosteroids are proven safe on bones. This was the finding of Jordana Schmier and his colleagues in their review of more than 260 studies. The group reviewed both published and unpublished literature and selected 14 studies that met their criteria. Majority of the studies reviewed included patients who received moderate to high doses of corticosteroid therapy.

From Bio-Medicine:

Previous studies have shown inhaled corticosteroids can decrease a person’s bone mineral density. However, researchers now say long-term use of ICS therapy is not associated with a significant change in BMD.

Corticosteroids are commonly used to treat asthmatics and people with chronic obstructive pulmonary disorder. Researchers say these medications are good at reducing inflammation and mucus production in the airways of the lungs.

Jordana Schmier and colleagues examined more than 260 studies and presented their findings at the Annual Scientific Assembly of the American College of CHEST Physicians in Orlando, Fla. They reviewed both published and unpublished literature and selected 14 studies that met their criteria. Researchers say the majority of the studies reviewed included patients who received moderate to high doses of corticosteroid therapy.

Results show long-term use of these medications by patients with asthma or COPD was not associated with significant changes in BMD. Schmier says using ICS therapy is important in controlling symptoms of various lung disorders. She concluded, “ICS treatment at standard doses in patients with asthma or COPD does not have a clinically meaningful effect on BMD.”

The researchers claim that inhaled corticosteroids do not cause significant effects on bone mineral density (BMD) of the patients. This conclusion was contrary to the findings of the previous studies which linked corticosteroids to bone loss.

Corticosteroids are prescribed to asthmatic patients and people with chronic obstructive pulmonary disorder (COPD) because these drugs reduce inflammation and mucus production in the airways of the lungs.

Children with Duchenne muscular dystrophy can walk longer for at least three more years. This is one of the findings in the study conducted in Ohio State University Muscular Dystrophy Clinic in Columbus. The experiment involved 143 boys who suffer from Duchenne muscular dystrophy. The patients were divided into two groups; one was given daily dose of corticosteroids, while the second group did not receive the medication.

Researchers found out that 91% of the patients who were treated with steroids were able to walk longer by themselves for at least 3.3 years. The treatment also helps reduce the risk of developing scoliosis.

From Science Daily:

For the study, researchers reviewed records of 143 boys seen at the Ohio State University Muscular Dystrophy Clinic in Columbus. Of the group, 75 had been treated with corticosteroids for an average of eight years and the rest of the boys had never been treated or had received a brief dose of steroids.

The study found boys who were treated with daily steroids walked by themselves 3.3 years longer than the untreated boys and had a lower rate of scoliosis, 31 percent compared to 91 percent.

However, the study found those boys being treated with daily steroids had an increased risk of vertebral and leg fractures. Vertebral fractures occurred in 32 percent of the boys treated with steroids, whereas there were no fractures reported in the untreated group. Leg fractures were 2.6 times more common in the steroid-treated group. King said this may be due to increased body weight and that the treated boys walked longer than the untreated group.

Although steroids treatment produces several benefits, it also come with some side effects such as high risk of vertebral and leg fractures.

Duchenne muscular dystrophy is a genetic disorder that occurs to every one of 3,500 boys age between nine and 11. There is no definite cure for this disorder.

Corticosteroids are known for its ability to reduce lung inflammation in cystic fibrosis. In fact, it treats many kinds of inflammation. These drugs help treat patients with fungus infection in the lungs by reducing the mucus and allowing them to breathe easier.

Corticosteroids can be given as a pill or liquid, as an injection, or with an inhaler. Oral corticosteroids are usually used for short periods of time because of its potential side effects, while inhaled forms can be used for long periods of time.

From WebMD:

Corticosteroids reduce inflammation in the lungs. They also decrease mucus and make it easier for the person to breathe. Corticosteroids can be given as a pill or liquid, as an injection, or with an inhaler. The kind of corticosteroid that will be prescribed depends on what symptoms are being treated.

They have been tested for use in treating lung inflammation in cystic fibrosis. At this time, they are recommended only for people who have significant shortness of breath and wheezing or an infection caused by a fungus (allergic bronchopulmonary aspergillosis).

Corticosteroids are the most powerful medicines for reducing inflammation in the lungs. More research is needed to find out the specific benefits and potential harmful side effects for people who have cystic fibrosis.

Using a spacer can help you avoid the side effects of inhaled steroids. After using an inhaler, it is also important to rinse your mouth out with water and then to spit out the water. Swallowing the water will increase the chance that the medicine will get into your bloodstream, which may increase the side effects of the medicine.

Since inhaled corticosteroids are prescribed for prolonged medications, doctors advise patients to rinse their mouths after using the inhaler to avoid the medicine to get into the blood vessels and reduce side effects.