According to a study, some children may not experience the same benefits of inhaled corticosteroids for keeping their asthma under control.
“There may be several reasons for our findings; It is possible that some children are genetically less responsive to steroids,” says researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston.
Several studies of adults with asthma have suggested that even rigorous use of inhaled steroids doesn’t lead to well controlled asthma in all adults, Dr. Sawicki noted. “But this issue hasn’t been looked at closely in children,” he said. “Further studies are needed to see what is different about children who don’t respond to steroids, to see if there is a way to predict whether a child will respond to inhaled steroids.”
Of the 914 children in the study, inhaled steroids were recommended for 435 who had persistent asthma, meaning they had symptoms on a regular basis. Among children who weren’t recommended for inhaled steroid treatment, most reported well-controlled asthma. Among those recommended for inhaled steroid treatment, 44% reported consistently using the medicine; 35% said they intermittently used the medicine and 21% said they didn’t use it at all.
“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”
“In addition to issues of medication adherence and inability to completely control for differences in underlying asthma, severity can never be completely ruled out,” Sawicki said.
Hein Verbruggen, the president of cycling’s governing body, has accused WADA of being “unprofessional” in leaking a confidential report on the Tour de France and has claimed the agency has a hidden agenda.
Verbruggen, who is also a leading member of the IOC, told the Guardian, “The report was leaked purposely.”
The International Cycling Union said yesterday that officials from WADA will no longer be able to attend cycle races as observers. Verbruggen claimed that the leak is linked to a dispute between the agency and the ICU over the use of corticosteroids by athleteswith a doctor’s prescription. “The leak happened exactly the day before WADA’s executive meeting is to pronounce on the list of banned substances,” said a statement.
The issue came to a head last July in the Tour de France when the race leader, Igor Gonzalez de Galdeano, tested positive for the asthma drug salbutamol. WADA said he would be positive under their rules but the ICU cleared him.
“The report was leaked to L’Equipe and today there is discussion about the list [of substances],” said Verbruggen. “It has been used to influence the situation; I have to come to that conclusion.”
Verbruggen also said, “I do not say WADA are always unprofessional but this shows an unprofessional attitude.”
A rare but devastating condition, affecting young males, could be effectively treated with steroids. Duchenne muscular dystrophy, the condition, can be treated with corticosteroids and steroid-administered patients can expect to walk for three additional years.
The magnitude of curvature and risk of scoliosis get reduced considerably when daily administration of steroids is made available to Duchenne muscular dystrophy patients, as per Wendy King, a physical therapist in the neurology department at Ohio State University. It was also remarked that calcium supplements and bone mineral density test must be undertaken at intervals of 6-24 months because of implications associated with steroids.
The reason for non-treatment with steroids was invariably parent refusal because of fear of side effects, the researchers said. The average duration of steroid use was 8.04 years.
The study found:
* Boys on steroids were able to walk independently, on average, 3.3 years longer than those who weren’t treated. The difference — from 9.21 years to 12.52 years — was significant at P<0.0001.
* The prevalence of scoliosis in the treated boys was 31%, compared with 91% among those not getting steroids, a difference that was significant at P<0.0001.
* The average scoliotic curve was 11.6 degrees in the treated boys, compared with 33.2 degrees in the untreated boys, which was also significant at P<0.0001.
* On the other hand, 32% of the treated boys had vertebral compression fractures versus none in those not getting steroids, which was significant at P<0.0012.
* The yearly long-bone fracture rate was 0.088 among the treated boys, but only 0.033 in the untreated group, difference by a factor of 2.6, which was significant at P<0.0032.
Several factors probably play a role in the increased rate of long-bone fractures, the researchers said, including prolonged independent walking and increased body weight because of the steroids.
The finding was disclosed in a study supported by the General Clinical Research Center at the Ohio State University and the National Center of Research Resources of NIH.
Psoriasis Cure Now, a nonprofit patient advocacy group, has urged a joint hearing of two Food and Drug Administration Advisory Committees for approving the over-the-counter (OTC) sale of specific topical steroidsthat presently require a prescription.
Topical corticosteroids play a big role for treating psoriasis patients all over the world and approximately 6.5 million people in the United States alone. The advocacy group remarked that OTC status of these steroidscan help in reducing medical costs and provide improved comfort.
Topical steroids come in dozens of variations in drug type and strength. One common classification system lists seven steroid potencies from mild to ultra high, with each of the seven classes offering numerous choices. For about 15 years, the strongest steroid available without a prescription has been hydrocortisone 1%, a very mild formulation.
In its statement to the FDA, the group called for better labeling and other education efforts both for patients and physicians about topical steroids and their potential side effects, and recommended particularly close attention to topical steroid use by pediatric psoriasis patients.
“While we believe additional steroids should be available OTC, we urge the FDA to weight carefully how best to educate parents who face difficult choices about how, and how aggressively, to treat psoriasis in their children,” Paranzino added. “Topical steroids play a role in treating many children with psoriasis, but there are non-steroid alternatives that should also be considered.”
Michael Paranzino, President of Psoriasis Cure Now, said that certain topical steroids require a prescription and can be safely used by psoriasis patients in an OTC setting.
A study published on bmj.com has reported that a single corticosteroid drug dose along with antibiotics could be used to alleviate pain besides proving itself as a better treatment option than the use of antibiotics alone. This study, however, was silent about similar benefits for children with sore throat.
Dr Matthew Thompson at the University of Oxford and collaborators expected the premise that corticosteroids could successfully ease sore throat symptoms due to their anti-inflammatory effects.
The results of eight trials were analyzed. They compared corticosteroids to placebo in adults or children. Overall, 743 patients were involved in the trial, including 369 children and 374 adults. They all had symptoms of severe sore throat.
In order to reduce partiality, variations in study feature and quality were considered.
Results showed patients given corticosteroids together with antibiotics were three times more likely to report total clearing up of pain after 24 hours than patients given placebo. After 48 hours the effect on pain was less evident. According to the authors, this indicates that a single dose of corticosteroids may be sufficient.
In addition, corticosteroids reduced the average time to pain relief by about six hours. But, the researchers specify that considerable effects were observed only in adult patients and only in those receiving oral corticosteroids. After assessing the trials, it was apparent that the use of simple painkillers made no difference.
The authors explain: “These findings suggest that, in patients with severe sore throat, pain can be reduced and resolution hastened by use of corticosteroids in conjunction with antibiotic therapy.” They write in conclusion: “These results may also help to prevent antibiotic use, particularly in the context of delayed prescribing. Future research should focus on the effect of corticosteroids independent of antibiotics.”
The associated editorial said steroidscould reduce pain in the first day but cautioned about absence of information on the possible harmful effects.
According to a study by scientists from the UT Southwestern Medical Center, treating pneumonia patients with steroidsand antibiotics is far better than treating them with antibiotics alone.
This study also suggested that the use of steroids is an effective option for treatment of inflammation in the lungs of a pneumonia patient. The study was headed by Dr. Robert Hardy, Study’s Senior Author & Associate Professor of Internal Medicine and Pediatrics.
From News-medical.net:
Adding corticosteroidsto traditional antimicrobial therapy might help people with pneumonia recover more quickly than with antibiotics alone, UT Southwestern Medical Center scientists have found.
Unlike theanabolic 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 steroidsand antibiotics recovered faster and had far less inflammation in their lungs than mice treated with antibiotics alone.
The study also remarked that a combination of antibiotics and steroids can be considered as one of the best treatment options available in present day times for treating patients during asthma (M pneumoniae infection) attack. It was also said that while antibiotics are good for killing the bug, steroids play an important role by treating inflammation in the lungs.
The findings of this study were supported by the National Institutes of Health.
The use of modern immunosuppressive drugs can reduce the need for a steroid therapy as early as seven days after a transplant surgery without an impact on maintenance of functions of the lung, according to a new study by researchers at UC.
Chronic health conditions that are considered to be common to kidney transplant recipients can be minimized via elimination of a daily dose of steroids, as per Steve Woodle, MD, Chief of UC’s transplant surgery division, principal investigator and designer of the study.
From Sciencedaily.com:
“Steroidshave long been the primary source of morbidity and complications following successful kidney transplantation,” Woodle says. “This study demonstrates that elimination of even small, daily prednisone (pred-ne-zone) doses does not compromise results while minimizing weight gain, diabetes and bone complications.”
Corticosteroidswere the first anti-rejection drug used in transplant patients, dating back to the first transplant surgeries over 50 years ago.
Traditionally patients who have undergone organ transplantation have required life-long steroid treatmentsgiven in combination with other drugs that help suppress the body’s immune system and allow the transplanted organ to function properly.
However, the steroid treatment—given as the oral drug, prednisone—can cause seriousside effects including cardiovascular disease, high cholesterol and blood pressure, weight gain, diabetes, bone weakness and cataracts.
It was remarked by Woodle that the risk of injection episodes in patients was marginally increased with an early steroiddiscontinuation process. He hopes that even this minor risk of increased rejection combined with long-term gains would not change much with development of new drugs and modern anti-rejection drugs.
Patients suffering from pneumonia can recover more quickly with a combination of corticosteroids and traditional antimicrobial therapy, as per scientists from the UT Southwestern Medical Center.
It is noteworthy to remember here that Corticosteroidsare generally used to treat inflammation in relevance to infectious disease unlike anabolic steroids that are used to bulk muscles.
In a study available online, researchers at UT Southwestern remarked that mice infected with a certain type of severe bacterial pneumonia and treated with a combination of steroidsand antibiotic therapy experience quicker recovery with less inflammation than a mice treated only with antibiotics.
From News-Medical.Net:
“Some people might think that if you give steroids, it would counteract the effect of the antibiotic,” said Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author. “But it turns out you need the antibiotic to kill the bug and the steroid to make the inflammation in the lung from the infection get better. The steroids don’t kill the bugs, but they do help restore health.”
Pneumonia is a lung infection typically characterized by breathing difficulties and spread by coughing and sneezing. Symptoms include headache, fever, chills, coughs, chest pain, sore throat and nausea. Pneumonia caused by the Mycoplasma pneumoniae bacterium is generally a less severe form of the disease that can occur in any age group. It accounts for 20 percent to 30 percent of all community-acquired pneumonia cases.
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 steroidin 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.”
It was remarked by Dr. Hardy that it is still very early to recommend steroids as a form of standard treatment for patients suffering from this kind of bacterial pneumonia, but he also remarked that the work does support the need for a clinical trial.
Meningitis is an inflammation of the meninges lining the brain. However, bacterial meningitis is potentially life-threatening, and requires hospitalization and treatment with antibiotics. Several different varieties of bacteria may cause meningitis, although the patterns have changed with the introduction of vaccines.
In the past years, both children and adult were given corticosteroidsin order to combat this disease. However, a study led by Dr. Samir Shah stated that corticosteroids given to children who are hospitalized for bacterial meningitis do not provide a benefit in survival or in reduced hospital stays.
Shah’s team analyzed medical records of 2,780 children with bacterial meningitis at 27 U.S. pediatric hospitals from 2001 to 2006. The median age of the children was nine months. Approximately 9 percent, or 248, of the children studied received corticosteroids, with steroid use doubling during the study period, from under 6 percent of children in 2001 to 12 percent in 2006.
There was no significant difference in mortality nor in time to hospital discharge, between children who received corticosteroids and those who did not. Overall, unadjusted mortality rates were 6 percent among children receiving corticosteroids, versus 4 percent among those not receiving them. There also was no significant difference in those outcomes between those receiving and not receiving corticosteroidsin the subsets of children with meningitis caused by pneumococcal bacteria or by meningococcal bacteria.
He added, “Our study shows the need for a further study in children — a large randomized clinical trial to examine all outcomes of steroid use, before the use of these medicines becomes routine in children with bacterial meningitis.”
Doctor Samir Shah emphasized that children are not just small adults to be readily prescribed with corticosteroids. He urged clinicians to consider whether the problems associated with corticosteroid use, such as gastrointestinal bleeding, outweigh any potential benefits
As per scientists from the UT Southwestern Medical Center, addition of corticosteroids to the traditional antimicrobial therapy is an effective option for helping pneumonia patients with quicker recovery than persisting with antibiotics alone.
It was remarked by Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author that while antibiotics are good enough to kill the bug, steroidsplay an important role for treating lung inflammation.
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.
The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection. Up to 20 percent of asthma attacks in children and adults have been shown to be triggered by this bacterium.
Dr. Hardy said it’s too early to recommend steroids as standard treatment for people with this type of bacterial pneumonia, but the work does support the need for a clinical trial.
It was suggested that this treatment methodology can open up the doors of a potentially new and effective treatment therapy for patients in the midst of an asthma attack also, which is caused by M pneumoniae infection.
According to a study, some children may not experience the same benefits of inhaled corticosteroids for keeping their asthma under control.
Hein Verbruggen, the president of cycling’s governing body, has accused WADA of being “unprofessional” in leaking a confidential report on the Tour de France and has claimed the agency has a hidden agenda.
A rare but devastating condition, affecting young males, could be effectively treated with 
Psoriasis Cure Now, a nonprofit patient advocacy group, has urged a joint hearing of two 
A study published on bmj.com has reported that a single corticosteroid drug dose along with antibiotics could be used to alleviate pain besides proving itself as a better treatment option than the use of antibiotics alone. This study, however, was silent about similar benefits for children with sore throat.
According to a study by scientists from the UT Southwestern Medical Center, treating pneumonia patients with 
The use of modern immunosuppressive drugs can reduce the need for a steroid therapy as early as seven days after a transplant surgery without an impact on maintenance of functions of the lung, according to a new study by researchers at UC.
Patients suffering from pneumonia can recover more quickly with a combination of 
Meningitis is an inflammation of the meninges lining the brain. However, bacterial meningitis is potentially life-threatening, and requires hospitalization and treatment with antibiotics. Several different varieties of bacteria may cause meningitis, although the patterns have changed with the introduction of vaccines.
As per scientists from the 