Steroids Blog

Patients with age-related macular degeneration (AMD) at all stages of the disease can benefit from cataract surgery, as per a published study in this month’s Ophthalmology, the journal of the American Academy of Ophthalmology (Academy).

It was revealed in the study that the steroid triamcinolone can prove very effective to treat diabetic macular edema (DME) patients when standard treatment options have failed to live up to the expectations.

From News-Medical.Net:

Cataract surgery improved vision in patients with any stage-from mild to advanced- AMD in the first study to include an adequate number of advanced AMD patients. Data was obtained from the multicenter, prospective Age-Related Eye Disease Study (AREDS), funded by the National Eye Institute (NEI), which was organized primarily to evaluate the effects of high-dose vitamin and mineral supplements on cataract and AMD. As the American population ages AMD prevalence is expected to rise, and many patients will concurrently develop cataract; both diseases can cause blindness if untreated.

“Earlier epidemiology had suggested cataract surgery might worsen AMD, so the data from the AREDS cohort study were evaluated to answer this important question,” said Emily Y. Chew, MD, who led the study for NEI.

Mark Gillies, PhD, lead researchers, remarked that IVTA (intravitreal triamcinolone) treatment can be considered by doctors while selecting advanced DME patients when standard treatment options have failed to deliver the expected results.

In a clinical study made by Dr. Kiumars Pirkalani of Mehr Medical Group in Tehran, Iran, it was found out that steroid-based therapy can induce hair growth in more than 90% of patients with alopecia universalis. The clinical evaluation starts with methotrexate and triamcinolone and then progresses through some of the same drugs used to treat rheumatoid arthritis.

According to Dr. Pirkalani, systemic corticosteroids can raise the patients’ response rate to about 70%, but short- and long-term side effects and frequent relapse after discontinuation make that therapy problematic.

From medpage today:

Methotrexate-based, steroid-sparing therapy has induced hair growth in more than 90% of patients with alopecia universalis, according to an ongoing clinical evaluation.

Based on evidence implicating autoimmunity in the hair loss, the therapy begins with methotrexate and triamcinolone and then progresses through some of the same drugs used to treat rheumatoid arthritis, Kiumars Pirkalani, M.D., of Mehr Medical Group in Tehran, Iran, said here at the International Congress of Dermatology.

“We have shown that, although this seems to involve many drugs, it will be potentially curative with short courses of therapy with the fewest side effects, if used intelligently,” said Dr. Pirkalani.

Conventional therapies for alopecia areata and its variants have proven unsatisfactory. Local irritants, such as diphencyprone and dithranol, induce hair growth in no more than half of patients and many of them cannot tolerate the therapies, said Dr. Pirkalani.

Combining triamcinolone with other drugs has typically led to higher response rates than those observed with triamcinolone monotherapy.

Doctor Pirkalani pointed out that conventional therapies for alopecia areata and its variants have proven unsatisfactory. Local irritants, such as diphencyprone induce hair growth in no more than half of patients and many of them cannot tolerate the therapies.

At the end of the study, 102 or 94% out of 109 patients have responded to weekly triamcinolone and methotrexate.