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Thursday 25, Nov 2010

  COPD management with steroids leads to reduced mortality rate

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COPD management with steroids leads to reduced mortality rateSignificant reductions in mortality rate can be noticed in COPD (chronic obstructive pulmonary disease) patients when inhaled corticosteroids are used.

This finding was disclosed by a study appearing in an issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP).

From Sciencedaily.com:

Dr. Macie and colleagues found that the mortality rates in patients 65+ who received inhaled corticosteroids were 11.7 percent, compared with 13.1 percent for those who did not. Patients in the younger group showed even greater results, with a mortality rate of 3.0 percent for patients receiving inhaled corticosteroids within 90 days, compared with 6.0 percent for those who did not, providing a mortality reduction rate of 53 percent. When patients who received steroids in the year prior were removed from the analysis, mortality was reduced by 34 percent. Researchers attribute this finding to multifactorial reasons, including reductions in exacerbations of the disease and suppression of inflammation.

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.

It was reported by this study that individuals making use of steroids paired with beta-agonists demonstrated a fall in cardiovascular-related death alone by 38 percent.

Friday 20, Aug 2010

  Reduced mortality rate seen with steroids for COPD management

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Reduced mortality rate seen with steroids for COPD managementAccording to a study appearing in an issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), mortality rate can be significantly reduced in COPD (chronic obstructive pulmonary disease) patients when inhaled corticosteroids are used.

The study reported that patients making use of steroids paired with beta-agonists experienced a fall in cardiovascular-related death alone by 38 percent.

From Sciencedaily.com:

Dr. Macie and colleagues found that the mortality rates in patients 65+ who received inhaled corticosteroids were 11.7 percent, compared with 13.1 percent for those who did not. Patients in the younger group showed even greater results, with a mortality rate of 3.0 percent for patients receiving inhaled corticosteroids within 90 days, compared with 6.0 percent for those who did not, providing a mortality reduction rate of 53 percent. When patients who received steroids in the year prior were removed from the analysis, mortality was reduced by 34 percent. Researchers attribute this finding to multifactorial reasons, including reductions in exacerbations of the disease and suppression of inflammation.

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.

W. Michael Alberts, MD, FCCP, President of the ACCP, said the study findings are intriguing for clinicians and suggest the need of future research for defining the roles and mechanisms of the effect of inhaled steroids on both cardiovascular and respiratory mortality.

Friday 30, Jul 2010

  COPD patients could benefit with steroids

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COPD patients could benefit with steroidsReduced mortality risk can be noticed in patients afflicted with chronic obstructive pulmonary disease (COPD) when they are treated with inhaled steroids.

It was remarked by Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada and author of the study that patients on steroids are relatively better protected than those not making use of them.

From Bio-medicine.org:

“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.

Dr. Macie also remarked that inhaled corticosteroids could be highly effective to prolong lives of patients with COPD.

Tuesday 27, Jul 2010

  Johns Hopkins experts made call for extra caution

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Johns Hopkins experts made call for extra cautionAccording to Lung disease experts at Johns Hopkins, physicians treating their patients afflicted with COPD (chronic obstructive pulmonary disease) need to observe extra caution while dealing with them.

It was remarked by lead author and pulmonologist M. Brad Drummond, M.D., M.H.S. that this finding has implications and serves a reminder to COPD patients so that they could take necessary preventive steps for avoiding pneumonia, which doubles their risk of death.

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.

As many as 11 million Americans are afflicted with COPD every year and a big majority of this population belongs to the category of past or present-day smokers.

Monday 26, Jul 2010

  Treatment involving inhaled steroids useful for COPD management

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Treatment involving inhaled steroids useful for COPD managementChronic obstructive pulmonary disease (COPD), which is one of the five leading causes of death worldwide, is characterized by an inflammatory response to inhaled fumes such as tobacco smoke that results in breath shortness, limited airflow, and loss of lung function.

Fluticasone propionate, which is an inhaled steroid, could minimize the ability of major pathogens for invading the respiratory epithelium, as per a study by Sebastian Albertí (Institut Universitari d’Investigacions en Ciències de la Salut, IUNICS, Palma de Mallorca, Spain) and colleagues.

From Medicalnewstoday.com:

Patients affected by COPD often suffer episodes of worsening of symptoms called acute exacerbations, mostly caused by bacterial infections. These episodes of exacerbation impact negatively on the health status of the patients, worsen their prognosis and are associated with a very significant social and economic cost.

Treatment with inhaled steroids, such as fluticasone propionate, reduces the frequency and severity of acute exacerbations in patients with COPD, but their role in controlling bacterial infection is controversial.

In healthy subjects the lung is sterile, but in patients with COPD it is not and bacteria like S. pneumoniae and H. influenzae is frequently isolated.

Findings of the study are expected to provide implications to physicians all over the world when it comes to treating COPD patients.

Sunday 18, Jul 2010

  Inhaled steroids effective for treating COPD

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COPD treatment is facilitated with inhaled steroidsPatients afflicted with chronic obstructive pulmonary disease or COPD can be effectively treated and experienced reduced mortality risk when treated with inhaled corticosteroids, as per a study appearing in the CHEST, which is a peer-reviewed journal of the American College of Chest Physicians (ACCP).

COPD patients who make use of inhaled corticosteroids benefit from improved survival rates as per Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada and author of this study.

From Bio-medicine.org:

“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.

COPD patients administered with inhaled steroids are relatively in a better position than those not using it, as per Dr. Macie. It was also revealed in the study that cardiovascular related deaths were reduced by as much as 38% and a 25% reduced all-cause mortality rate was noticed among patients administered with inhaled corticosteroids within thirty days of discharge from the hospital.

Friday 25, Jun 2010

  Inhaled corticosteroids helpful for COPD patients

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Inhaled corticosteroids helpful for COPD patientsReduced mortality risk is experienced in patients with COPD (Chronic obstructive pulmonary disease) who are administered with inhaled corticosteroids. This finding was disclosed in a study published in the CHEST, peer-reviewed journal of the American College of Chest Physicians (ACCP).

It was said by Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada and author of the study that inhaled corticosteroids are effective in prolonging lives of patients with COPD.

From Bio-medicine.org:

“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.

COPD patients who are using inhaled corticosteroids are relatively better protected than those not making use of them, as per Dr. Macie.

Tuesday 08, Jun 2010

  Macrolide antibiotic use can minimize COPD exacerbations

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Macrolide antibiotic use can minimize COPD exacerbationsAccording to a London-based study, frequency of exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD) can be reduced by almost 35 percent with the use of a macrolide antibiotic in the long term.

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 that there is a significant effect of low-dose macrolide therapy on the 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 study results 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.

Sunday 16, May 2010

  COPD patients using inhaled steroids at risk for severe pneumonia

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COPD patients using inhaled steroids at risk for severe pneumoniaMedical practitioners generally recommend inhaled steroids to patients affected by Chronic Obstructive Pulmonary Disease (COPD) but a study has found out that these anti-inflammatory drugs could increase the risk of pneumonia.

It was remarked by the researchers that present inhaled corticosteroid use was linked with a significant 70 percent increase in the risk of being hospitalization for pneumonia. This remark came after evaluating a large cohort of patients with COPD.

From Sciencedaily.com:

Pierre Ernst, M.D., a clinical epidemiologist at McGill University, Canada, along with three other researchers from the university’s department of medicine, analyzed the hospitalization and drug prescription information from 1988 to 2003 of 175,906 patients with COPD living in Quebec, Canada. During that time, 23,942 of the patients were hospitalized for pneumonia.

In their report, the researchers noted that the admission rate for pneumonia increased with higher doses of inhaled steroids and that reduction in risk was observed once the medications were stopped. Among all patients taking inhaled steroids, there was a 53 percent increase in pneumonia deaths within 30 days of being admitted to the hospital.

The investigators noted that these findings are particularly relevant, given that pneumonia is the third leading cause of hospitalization in the United States and that inhaled corticosteroid use among patients with COPD increased from 13.2 to 41.4 percent from 1987 to 1995.

These findings were reported in the second issue of the July American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Saturday 24, Apr 2010

  Risk of pneumonia can increase dramatically with inhaled corticosteroids

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Risk of pneumonia can increase dramatically with inhaled corticosteroidsA great sense of caution has been recommended by lung disease experts at John Hopkins when it comes to prescribing inhaled corticosteroid drugs to patients with chronic obstructive pulmonary disease (COPD).

This caution call was made after evidence was found suggesting that a widely used anti-inflammatory medication increases the risk of pneumonia by a full third.

It was remarked by the researchers that it is not clear why the corticosteroid treatment increases the risk but it is suspected that it is because corticosteroids suppress the immune system.

From Sciencedaily.com:

In breaking down the overall rise in risk, the researchers found that in people taking the highest possible dose of each inhaled corticosteroid, there was a 46 percent increase in risk for pneumonia. Infection risk nearly doubled in those who had less than 40 percent normal lung function, as opposed to those whose lungs were stronger.

Drummond says the absence of an overall difference in death rates between users and non-users of corticosteroids was likely due to the short-term follow-up of three years or less across all of the studies.

Fan says further research is needed to identify precisely which groups benefit long-term and which ones do not from inhaled corticosteroids, and to see if there is a link between higher risk and death.

He notes that COPD kills more than 120,000 Americans every year and is expected to become the nation’s third leading cause of death in the United States by 2020, ahead of stroke and behind heart disease and cancers.

Funding for this latest study was provided by The Johns Hopkins Hospital’s General Clinical Research Center.

Pulmonologist M. Brad Drummond, M.D., M.H.S., led the study and was supported by Eddy Fan, M.D.; other researchers involved in this study, conducted solely at Hopkins, were Elliott Dasenbrook, M.D., M.H.S.; Marshall Pitz, M.D., M.H.S., now at the University of Manitoba, in Winnipeg, Canada; and David Murphy, M.D.

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