More and more patients suffering from Chronic Obstructive Pulmonary Disease (COPD) are relying upon inhaled corticosteroids for controlling exacerbations of the disease but this practice does not get any support from a recent study.

The study found out that the anti-inflammatory drugs increase the risk of pneumonia development in such patients leading them to face hospitalization.

From Bio-Medicine.Org:

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.

Adverse effects of inhaled corticosteroids in patients with COPD, the authors said, are particularly troublesome given the limited evidence for their efficacy.

Pierre Ernst, M.D., a clinical epidemiologist at McGill University, Canada, along with three other researchers from the university’s department of medicine, analyzed hospitalization and drug prescription information from 1988-2003 of 175,906 patients with COPD and living in Quebec, Canada.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, steroids

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Patients with COPD (Chronic obstructive pulmonary disease) and being administered with inhaled corticosteroids experienced lower mortality risk than their counterparts not on steroids, as per a new study published in the CHEST, peer-reviewed journal of the American College of Chest Physicians (ACCP).

It was remarked by Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada and author of this study that COPD patients on corticosteroids benefit from longer survival durations.

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 said that patients on inhaled corticosteroids are relatively better positioned to stay protected than those not using them.

Tags: chronic obstructive pulmonary disease, COPD, inhaled corticosteroids, steroids

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A new treatment option may help people with chronic asthma to manage their condition with a single prescribed inhaler that contains two medicines, as per a review.

Lead reviewer Christopher Cates, M.D., at the Community Health Sciences of St. George’s at the University of London, said that most asthma patients default on inhaled corticosteroids as inhaled steroids do not bring immediate difference to asthma symptoms.

From Sciencedaily.com:

The Cochrane reviewers found no significant reduction in the number of asthma exacerbations that required hospitalization among the patients who used single inhaler therapy.

However, the reviewers did find that fewer adults on single inhaler therapy had exacerbations needing a course of oral corticosteroids. Compared with 18 people of 100 in the control inhaled corticosteroid group who had an exacerbation treated with oral steroids over 11 months, there were 11 of 100 for the single inhaler therapy group.

“One attraction of the combined inhalers is that the inhaled corticosteroid is automatically taken with the beta-agonist, which does relieve symptoms,” said Cates. “Single-inhaler therapy takes this one stage further, as the inhaled corticosteroid is automatically increased, with the beta-agonist, if the asthma symptoms worsen. This approach shows clear advantages in comparison to taking inhaled corticosteroids alone, but is less convincing when compared to current best practice.”

Carlos Camargo, M.D., an associate professor of medicine at Harvard Medical School, specializes in asthma and chronic obstructive pulmonary disease, remarked that this single-inhaler therapy is an interesting approach to treat chronic asthma.

Tags: Asthma, chronic asthma, chronic obstructive pulmonary disease, corticosteroids, Inhaled steroids, steroids

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Entest BioMedical Inc. (OTC Bulletin Board: ENTB) recently filed a third patent application related to the area of COPD (chronic obstructive pulmonary disease).

COPD affects more than five million people in the United States alone and results in 120,000 deaths on a yearly basis.

It is worth noting here that a recent article “Immunologic aspects of chronic obstructive pulmonary disease” by Cosio et al in the June 4th, 2009 issue of New England Medical Journal had suggested that COPD is more of an active immunological attack than just a disease of inflammation.

From News-Medical.Net:

“To date Entest has filed two previous patent applications covering use of fat stem cell components in COPD and methods of using photoceuticals to enhance stem cell therapy. The current patent application has a variety of derivative uses outside of COPD including treatment of transplantation rejection, and other disease in which the immune system has gone awry,” stated David Koos, Entest’s CEO.

The essence of the technology is the use of existing implantable devices to deliver chemical/protein signals that specifically stop inflammatory reactions in a manner that is more in tune with biological processes. Instead of us “telling the body” what it should do with a blunt-force approach, as is the standard of care, the current invention uses more natural and slow acting interventions.

Dr. Stephen Josephs, inventor of the technology, remarked that importance of the inflammatory process in COPD is exemplified by usage of broad-acting steroids known to minimize inflammation but they can bring adverse effects.

Tags: chronic obstructive pulmonary disease, COPD, stem cell therapy, steroids

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According to a new study that was published in an issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), chronic obstructive pulmonary disease (COPD) patients using inhaled corticosteroids are likely to have a considerably reduced mortality risk.

It was revealed by the researchers that patients receiving inhaled corticosteroids within a period of 30 days of hospital discharge had a 25 percent reduced all-cause mortality rate. It was also noted that patients using steroids paired with beta-agonists saw 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, said that COPD is an underrated lung ailment that has associated lung disease.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, inhaled corticosteroids

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After an evidence was found suggesting that some of the presently-used anti-inflammatory medications increase the risk of pneumonia by a full third, Lung disease experts at Johns Hopkins made a call for caution while recommendations are made by doctors while prescribing inhaled corticosteroids to people with COPD (chronic obstructive pulmonary disease).

COPD is believed to affect more than 11 million Americans on a yearly basis and most of this affected population belongs to the category of present or former 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.

Pulmonologist M. Brad Drummond, M.D., M.H.S., who led the study, remarked that findings of this study are expected to provide a reminder to patients with severe lung disease to plan and take steps for reducing the risk of pneumonia, which doubles their risk of dying.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, inhaled corticosteroids, pneumonia

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The use of a macrolide antibiotic may possibly reduce exacerbations in patients with moderate to severe COPD (chronic obstructive pulmonary disease) by as much as 35 percent, as per a London-based study.

According to lead author of the paper, Terence A. R. Seemungal, Ph.D., and Jadwiga Wedzicha, M.D., principle investigator, low-dose macrolide therapy can provide considerable effect in terms of reductions in frequency of exacerbation and severity with moderate to severe COPD.

From News-Medical.Net:

The researchers found that not only did the patients randomized to receive erythromycin have fewer exacerbations, but among the patients studied, 60 percent of the exacerbations that occurred were within the placebo group. While the number of exacerbation-related hospitalizations was small, more than twice as many occurred among the placebo group—14 versus 6. The median duration of exacerbations from onset to resolution of symptoms was 9 days in the erythromycin group and 13 days in the placebo group.

“Our results did not allow us to determine a mechanism for these findings. However based on in-vitro studies we suspect that the mechanism is likely to involve the anti-inflammatory properties of erythromycin,” noted Dr. Seemungal.

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.”

John Heffner, M.D., past president of the ATS, said present considerable health implications are highlighted by observations that intervention might possibly reduce the frequency and severity of acute exacerbations in COPD.

Tags: chronic obstructive pulmonary disease, COPD, erythromycin, exacerbation, macrolide antibiotic, macrolide therapy

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A call for greater caution for prescribing inhaled corticosteroids to people with COPD (chronic obstructive pulmonary disease) was made by Lung disease experts at Johns Hopkins. The call was made after evidence suggested that some of the most widely-used anti-inflammatory medications may increase the risk of pneumonia by a full third.

It is considered that more than eleven million Americans are suffering from COPD and many of them belong to the former or current smokers’ category.

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 of this study, pulmonologist M. Brad Drummond, M.D., M.H.S., said that the latest finding is a reminder to the medical fraternity and patients with severe lung disease to plan and take steps to reduce the risk of catching pneumonia, which doubles their risk of dying.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, inhaled corticosteroids, pneumonia

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According to a study, a significantly reduced mortality risk may be seen in patients with chronic obstructive pulmonary disease (COPD) and using inhaled corticosteroids.

It was shown by the research that patients receiving inhaled corticosteroids within 30 days of hospital discharge had a twenty-five percent minimized all-cause mortality rate while numbers of cardiovascular-pertaining death alone in patients using steroids paired with beta-agonist were reduced by thirty-eight percent.

From News-Medical.Net:

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.

Author Christine Macie, MD, FCCP, Cambridge Hospital, Ontario, Canada, remarked that this study analyzed the effect of inhaled corticosteroids on survival and the study results suggest that survival is longer in patients using inhaled corticosteroids.

Tags: chronic obstructive pulmonary disease, COPD, inhaled corticosteroids, steroids

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Lung disease experts at Johns Hopkins have recommended a call for following greater caution while prescribing inhaled corticosteroids to people suffering from COPD (chronic obstructive pulmonary disease).

The call was made immediately after it was found that some of the most commonly used anti-inflammatory medications used to treat COPD can increase the risk of pneumonia by a full third.

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.

Pulmonologist M. Brad Drummond, M.D., M.H.S., who led the study, remarked that the findings of this study are believed to serve as an urgent reminder to all those patients with severe lung disease to take necessary steps for reducing the risk of catching pneumonia, which can double their risk of dying.

Tags: chronic obstructive pulmonary disease, COPD, corticosteroids, inhaled corticosteroids, pneumonia

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