Steroids Blog

Even though asthma is one of the major reasons for admissions to hospitals and a common chronic disease among young children yet 26-45 percent of children face inadequate asthma control, as per a review in CMAJ (Canadian Medical Association Journal).

This review was produced as an initiative of the Canadian Thoracic Society and incorporated the latest scientific information derived from randomized controlled trials since the Canadian Pediatric Asthma Consensus Guidelines were published in 2003.

From Sciencedaily.com:

The review provides key points for distinguishing between transient asthma and chronic asthma in preschoolers and information on managing both types.

For children with intermittent asthma, using inhaled corticosteroids only during attacks does not appear to be effective. Regular therapy with inhaled steroids should be used for children with more severe intermittent or persistent symptoms. Treatment with leukotriene receptor antagonists during the viral season may help to reduce symptoms and visits to health care providers. The possibility of another condition should be considered if children do not respond to optimal therapy.

The authors stated that more research is pending to examine the effectiveness of treatment options in young children.

Adding an antiviral agent to corticosteroids is not additionally effective or beneficial when it comes to ensuring improved facial movement while treating Bell’s palsy patients, as per a meta-analysis of previously published studies in the June issue of Archives of Otolaryngology-Head & Neck Surgery.

Bell’s palsy is the most common cause of facial paralysis and affects around 20-45 per 100,000 on a yearly basis.

From News-Medical.Net:

“Treatment decisions regarding patients with Bell’s palsy are doubtful and remain a common problem in medical practice. Corticosteroids have been established as the therapy of choice, despite the fact that the available evidence from randomized controlled trials does not exhibit a clear benefit. However, the largest available randomized controlled trial published recently suggested a benefit from the use of corticosteroids in patients with idiopathic [of unknown cause] acute facial paralysis,” the authors conclude.

“Additional well-designed randomized controlled trials are needed to assess the potential value of antiviral addition to the recovery of facial palsy with more confidence. However, based on the currently available evidence, the addition of an antiviral agent to corticosteroids for the treatment of patients with Bell’s palsy is not justified.”

Some of the presently used treatment options include antiviral therapy, corticosteroids, or a combination of the two.

The study noted that adding antiviral agents to corticosteroids does not result in any additional benefit.

Crohn’s patients can now expect relief from Naltrexone, an FDA-approved drug, which is presently used to ease withdrawal symptoms from substance abuse.

This drug is currently prescribed and used for easing symptoms of drug and alcohol addiction and considered to bring relief to Crohn’s patients, according to a Penn State College of Medicine pilot study.

From News-Medical.Net:

Typical treatment for Crohn’s involves using steroids or corticosteroids, which suppress the immune system and can have other toxic side effects. Treatment is often time-intensive and expensive, as well.

“This is a novel approach to treating a common disease, and it’s simple, it’s safe, and it costs far less than current standards of treatment,” Smith said. “We don’t yet know the exact mechanisms involved in how it works, but we’re working on that as well.”

Smith initiated the study using a Dean’s Feasibility Grant — a program designed to encourage investigators to design trials in their area of expertise and seek outside funding. The National Institutes of Health (NIH) recently awarded the College of Medicine $500,000 for the team to continue the study.

These findings were presented by Jill P. Smith, a gastroenterology specialist and researcher at the College of Medicine and Penn State Milton S. Hershey Medical Center in Los Angeles at the National Association of Gastroenterologists annual Digestive Diseases Week conference.

According to a report from Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, Abbott/Eisai’s Humira is about to earn Gold Standard Status for UV (Ulcerative Colitis) in 2012.

The report consisted of the fact that surveying gastroenterologists have been successful in finding the effect of a therapy on remission induction. This effect is considered to be an important attribute in influencing research decisions in a positive manner in moderate to severe ulcerative colitis (UV). It was also revealed that corticosteroids have an advantage over Remicade in this attribute.

From Bio-Medicine.Org:

The new report entitled Ulcerative Colitis: Opportunity Awaits Therapies That Treat Moderate to Severe Disease More Effectively Than Infliximab finds that a drug that maintains remission in a higher percentage of patients with moderate to severe ulcerative colitis than infliximab at one year would earn a 30 percent patient share in the United States and a 15 percent patient share in Europe, according to surveyed U.S. and European gastroenterologists.

In 2008, Decision Resources’ proprietary clinical gold standard for ulcerative colitis was prednisone. Based on available data and expert opinion, Abbott/Eisai’s Humira (adalimumab) will earn gold-standard status for ulcerative colitis in 2012, following its approval for the indication in 2011. Interviewed experts believe that adalimumab has potential to be superior in maintenance of remission when compared to infliximab.

Decision Resources Analyst Benjamin Guikema, Ph.D., remarked that adalimumab is far better than infliximab for maintenance setting. The fact that adalimumab provides a reduced risk of prominent organ besides being more safe and tolerable as compared to any other present-day drug was the reason behind study findings.

People are not aware of the fact that steroids can be very useful in curing diseases which do not have a proper treatment. However, still the negative aspect of steroids is believed by people that it is ineffective and harmful. Another class of steroids known as corticosteroids is used to treat infection related to inflammation and swelling such as bacterial meningitis.

In studies seen online, we see these steroids were tested on mice infected by bacterial pneumonia was treated with a combination of antibiotics and steroids. It showed a positive result with a high percentage reduction in inflammation of lungs and recovered faster on comparing with the one only treated with antibiotics.

From Science daily:

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.

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.

Here studies showed that both the antibiotic and the steroids had equal part in curing pneumonia though antimicrobials still remain one of the major primary therapies to cure pneumonia. The antibiotic is used to kill the microbe and steroids to reduce inflammation.

Moreover it was also seen that this combination was far more effective in curing pneumonia with patients already suffering from asthma. Although Dr. Hardy mentioned that it was too early to recommend these steroids for treatment as the work still depends on the clinical trial.

In a report published in the Journal of Infectious Diseases, a trial conducted by the group of Dr. Robert Hardy of the University of Texas Southwestern Medical Center stated that steroids can reduce Mycoplasma pneumonia bacteria. The trial was initially conducted on mice infected with the Mycoplasma pneumoniae bacterium.

The researchers analyzed four groups of mice that were treated daily with either the antibiotic clarithromycin alone, the corticosteroid dexamethasone alone, a combination of clarithromycin and dexamethasone, or placebo.

From medpage today:

Giving corticosteroids to Mycoplasma pneumonia patients taking traditional antimicrobial therapy may help them recover faster, suggested a study with mice reported here.

Mice infected with the M. pneumoniae bacterium that were treated with both steroids and antibiotics recovered faster and had less inflammation in their lungs than mice treated with antibiotics alone, Robert Hardy, M.D., of the University of Texas Southwestern Medical Center, and colleagues reported online in the Journal of Infectious Diseases.

Recent observational reports, however, have indicated that adding steroids to antimicrobial therapy may improve outcomes for patients with severe Mycoplasma pneumonia. But these have only been case reports and were not fully investigated in trials, the researchers said.

The mice were evaluated at baseline and after one, three, and six days of therapy.

After three days of treatment, combination therapy significantly reduced lung histopathologic scores compared with all three other therapies. Mice treated with clarithromycin alone had significantly reduced quantities of M. pneumoniae in lavage fluid compared with those treated with placebo. But after six days, mice treated with clarithromycin monotherapy and combination therapy both had reduced levels of the bacteria.

The research group concluded that corticosteroids added to the traditional antimicrobial therapy help treat Mycoplasma pneumonia. The group suggested that human trials must be done to determine other benefits and the potential side effects of the treatments.

Patients with vestibular neuritis experience nausea and vomiting caused by viral infection of the vestibular nerve. This causes dizziness and imbalance but it won’t result to deafness.

A study revealed that corticosteroids such as methylprednisolone help in the recovery of patients with vestibular neuritis.

From Bio-Medicine:

Vestibular neuritis causes dizziness due to a viral infection of the vestibular nerve.

Researchers conducted a study to see if a steroid drug, antiviral agent, or a combination of the two could improve the outcome of patients with vestibular neuritis. For the study, 141 patients who were diagnosed with vestibular neuritis were randomly assigned to one of the treatment groups. The treatment groups included the corticosteroid group (that received methylprednisolone, also known as Medrol), the antiviral agent group (that received valacyclovir, also known as Valtrex), a group that received both, and a group that received placebo.

Researchers found that 62 percent of the patients on the steroid improved compared to 39 percent in the placebo group, 36 percent in the antiviral group and 59 percent in the combination group. Researchers say the antiviral drug clearly did not improve the outcome in patients with vestibular neuritis despite the assumed viral cause. In fact, the steroid-alone group had better outcomes than the steroid-antiviral combination group.

The study involved 141 patients of vestibular neuritis who were divided into several groups. One group was given methylprednisolone, while the other group was administered with antiviral agent. The rest of the patients were given with placebo and combination of antiviral and steroid treatments. The researchers made two follow-ups on the patients after the treatment. One was after the treatment and the next was 12 months after.

The study which included 141 patients revealed that 62% who were treated with methylprednisolone showed improvement in their condition. The researchers are considering that steroids may be of great help in tre ating vestibular neuritis.

As per a study by UT Southwestern Medical Center Scientists, steroids in conjunction with antibiotics can help pneumonia patients to recover in a quicker way than those recovering with antibiotics alone.

This study which was headed by Dr. Robert Hardy, Study’s Senior Author & Associate Professor of Internal Medicine and Pediatrics, suggested that usage of steroids can be done with antibiotics to treat inflammation in the lungs of a pneumonia patient.

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 also suggested that the combination of antibiotics and steroids is an effective therapy for pneumonia patient during an attack of asthma (M pneumoniae infection). It was also remarked in the study that while usage of antibiotics is a good option to kill the bug, steroids can prove to be beneficial for treating inflammation in the lungs.

The findings of this study were supported by the National Institutes of Health.

According to the study headed by Dr. Ronald Wapner, corticosteroids called betamethasone which helps reduce neonatal mortality may also produce potential harm to babies. This type of corticosteroids given to women who are at risk of having premature delivery to stimulate the lungs development of their babies, is found to cause cerebral palsy among babies who are given multiple courses.

From ScienceDaily:

Repeated courses of a drug that is used to improve the survival of unborn premature babies also may increase the risk of cerebral palsy in those children, according to results from a multi-center study, funded by the National Institutes of Health and led by Ronald Wapner, M.D., professor of obstetrics and gynecology, Columbia University Medical Center and attending obstetrician and gynecologist at NewYork-Presbyterian Hospital/Columbia.

The drug – a corticosteroid called betamethasone – is given to women at risk of premature delivery to hasten the development of their baby’s lungs. The study, performed by members of the NIH-sponsored Maternal-Fetal Medicine Network followed a total of 556 infants at the Morgan Stanley Children’s Hospital of NewYork-Presbyterian Hospital/Columbia and 12 other sites around the country, and found that by ages two to three, the two groups of children were physically and neurologically identical, except that six out of 248 children who received multiple courses of corticosteroids had been diagnosed with cerebral palsy, compared to only 1 out of 238 children in the placebo group. The mothers of all six children with cerebral palsy in the corticosteroid group had received four or more courses of the drug.

The study conducted by members of the NIH-sponsored Maternal-Fetal Medicine Network at the Morgan Stanley Children’s Hospital showed that that six out of 248 babies age two to three who received multiple courses of corticosteroids had been diagnosed with cerebral palsy, compared to only 1 out of 238 children treated with placebo.

Studies shown by Childhood Asthma Management Program (CAMP) clinical trial reveals that a continued treatment of asthma along with steroids leads to a better result than not using them. The trial as conducted on 1000 children aged between 5-12 and were divided into three groups, out of which one was given the steroid budesonide twice-daily and an inhaled corticosteroid medication; the other received nedocromil, an inhaled non-steroid medication; and third group received a placebo.

From science daily:

Results from the original CAMP trial showed that using budesonide twice daily led to fewer hospitalizations and urgent care visits, fewer days in which additional asthma medications were needed and a reduced need for albuterol, a fast-acting drug for relief of acute asthma symptoms. Using nedocromil twice daily reduced urgent care visits and courses of oral steroids for severe symptoms, but did not affect the number of hospitalizations, symptoms or airway responsiveness.

“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.”

Though with age, the symptom of asthma is reduced since the patient gets acquainted with the disease and manages on its own whereas it still resides in the body.

As studied by Robert C. Strunk, M.D., a Washington University pediatrician at St. Louis Children’s Hospital and lead author of the study, after five years that Inhaled corticosteroids such as budesonide was most effective form of anti-inflammatory treatment for asthma by controlling symptoms and improving pulmonary function, led to fewer hospitalizations and urgent care visits. Unlike nedocromil twice daily reduced urgent care visits and courses of oral steroids for severe symptoms, but did not affect the number of hospitalizations, symptoms or airway responsiveness.