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.

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.

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.

As per a recently concluded study, inhaled corticosteroids are more effective than sodium cromoglycate for treating asthma along with helping a lending hand to the lung to function in a normal way.

The study remarked that the superiority of inhaled corticosteroids tends to increase with its moderate low doses, compared to its low doses, as per Dr James Guevara, Department of Pediatrics at the University Of Pennsylvania School Of Medicine in Philadelphia and lead review author of this study.

From News.Bio-Medicine.org:

Inhaled corticosteroids (ICS) and sodium cromoglycate (SCG) are both used to help people with asthma. SCG is believed to have a low risk of causing long-term side effects, but despite anxieties relating to routine use of steroids, the use of ICS has steadily increased since the 1990s.

While they are both known to work, there has previously been a debate as to whether one is superior to the other.

By pooling data from randomized controlled trials that directly compared the effects of ICS and SCG the Cochrane Review Authors could assess the relative benefits of each. They considered measures of lung function, asthma control and the use of general healthcare services such as GPs and hospitals.

Their conclusion was that ICS controls asthma better than SCG and that it also leads to improved lung function. They were, however, unable to decide whether there were differences in side-effects as most of the trials ran for too short a time to assess long-term outcomes.

“The superiority of ICS over SCG appears to increase when patients use moderate doses of ICS, compared with when low doses of ICS are used,” says lead Review Author Dr James Guevara, who works in the department of Pediatrics at the University of Pennsylvania School of Medicine in Philadelphia.

Inhaled Corticosteroids have the ability to control asthma in a better manner than sodium cromoglycate and seems to be a better option for patients with asthma, DR Guevara concluded.

The study is believed to benefit almost more than one million asthma patients in the United States alone. This study has been accepted by the medical fraternity as a new ray of hope for future treatment developments in asthma management.

As per a recently concluded study, it was revealed that children being administered with inhaled corticosteroids such as budesonide in the past have not been able to show those improvements after stopping the steroid treatment. These results were observed after the Childhood Asthma Management Program (CAMP) clinical trial announced its findings on more than 1,000 children in the age group of 5-12 years.

During the study, it was found that children (now in their late teens) who have been advised steroid therapy in the past and stopped now showed no differences in management of asthma when they were compared with children who received the placebo.

Robert C. Strunk, M.D., a Washington University pediatrician at St. Louis Children’s Hospital and lead author of the study, said that it was quite interesting to note that children tend to do better with the passe of age when it comes to combating asthma.

Inhaled corticosteroids such as budesonide have been regarded as one of the most effective forms of anti-inflammatory treatments for controlling asthma via improving pulmonary function.

From Sciencedaily.com:

“While the kids did get better with age and didn’t seem to need the medicine as much, laboratory measurements indicated that they were still having symptoms, and therefore were primed to an attack if they got a bad cold or were exposed to a significant weather change,” Strunk said.

The researchers determined that continued benefit of these medications likely requires continued use.

“The conclusion is that some kids get better, but the doctor, family and the patient have to pay attention to the symptoms,” Strunk said. “Some of the kids are going to need medicine, and they have to be honest about that possibility.”

In another part of the follow-up study, researchers looked at long-term side effects of the steroid medications on growth, bone density and fracture rate. The only side effect of budesonide was a 0.4-inch decrease in height among female patients compared to the patients who took a placebo during the trial. However, one-fourth of the girls and more than half of the boys in the trial had not reached final adult height at the end of the post-trial period, researchers said. There were no effects of the nedocromil treatment on growth.

Funding from the National Heart, Lung, and Blood Institute and the National Center for Research Resources supported this research.

The study also suggested that if an asthma patient gets cured after being administered with steroid treatment then he should not stop the treatment presuming that asthma is completely cured. It was found that continued benefits of steroid medications require continued usage.