Patients who receive kidney transplants who are withdrawn from corticosteroid-based immunosuppression (CSBI) as early as possible after transplantation have significantly lower fracture rates compared with patients who continue receiving corticosteroids.

This finding was presented by a research presented at the American Society for Bone and Mineral Research (ASBMR) 2011 Annual Meeting.

From Medscape.com:

Corticosteroids are known to be toxic to osteoblasts, and the drugs are typically given in exceptionally high doses after kidney transplants, potentially causing substantial bone loss, said coauthor Thomas L. Nickolas, MD, from Columbia University Medical School in New York City.

“Kidney transplant patients typically initially get very high intravenous doses of corticosteroids that are tapered down to a high oral dose, then to a small oral dose, by 6 months, but it is in that first 6 months after transplantation when the majority of bone loss occurs,” he explained.

Studies show that the bone loss at the lumbar spine and the hip during that initial 6 months posttransplantation can range from 2% to as much as 10%, he said.

The study was supported by the Doris Duke Charitable Foundation.

Tags: corticosteroid, corticosteroids

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Chemotherapy for lymphoma should be recognized as a risk factor for the development of osteoporosis, according to Dr. Bhaskar Dasgupta in a poster session at the annual meeting of the British Society for Rheumatology.

Dr. Dasgupta, director of rheumatology, Southend Hospital NHS Trust, Westcliff on Sea, England, said patients with lymphoma have greatly improved survival rates because of advances in treatment, but their quality of life may be compromised by long-term complications of chemotherapy.

From Internalmedicinenews.com:

Height loss as a surrogate marker for vertebral osteoporosis was evaluated in a study of patients attending a lymphoma clinic. A total of 25 patients, 8 with Hodgkin’s and 17 with non-Hodgkin’s lymphoma, were enrolled. Mean age was 57.6 years, and 13 of the patients were female, reported Dr. Dasgupta. Exclusion criteria included a previous osteoporosis diagnosis, lymphoma with spinal involvement, and previous corticosteroid treatment.

When baseline height was compared with height 24 months or more after chemotherapy, the mean loss was found to be 22.8 mm, according to Dr. Dasgupta.

The degree of height loss increased with age—every 10-year increase in age was associated with a 5.2-mm decrease in height, he reported. No association was seen between height loss and gender, and none of the patients had other risk factors for osteoporosis.

No height loss association was found with either cumulative steroid dose or the type of chemotherapy received.

Osteoporosis is a complication that can result from treatment with alkylating agents and the steroids that are usually given with chemotherapy.

Tags: chemotherapy, corticosteroid, osteoporosis, steroid dose, steroids

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A study by researchers at Washington University School of Medicine and other institutions has suggested that dose changes (steroids) and/or addition of new drugs to the asthma therapy can provide relief to patients.

Robert C. Strunk, M.D., and Leonard B. Bacharier, M.D., both Washington University pediatric asthma specialists at St. Louis Children’s Hospital were co-authors for this study.

From Sciencedaily.com:

“We used a few complicated and expensive tests we thought would help us determine which drug would be better, but they didn’t help, so we can avoid these tests,” says Strunk, the Donald Strominger Professor of Pediatrics at Washington University School of Medicine.

Although 98 percent of patients in the study showed improvement on at least one of the step-up options, there were still 120 asthma exacerbations, or attacks, among the 165 patients that required treatment with prednisone, a corticosteroid commonly used after an exacerbation that prevents the release of inflammatory substances in the body. Bacharier says that indicates none of these treatments provide perfect asthma control.

“There may not be an ideal therapy for every patient, but these step-up treatments allow for improved asthma control and outcomes over leaving them on low-dose steroids alone,” Bacharier says.

The study was published online March 2, 2010, by the New England Journal of Medicine and presented the same day at the American Academy of Allergy, Asthma and Immunology’s annual meeting in New Orleans.

Tags: Asthma, asthma therapy, corticosteroid, Prednisone, steroids

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Progression of a complication of diabetes, diabetic retinopathy, could be slowed down by injecting Triamcinolone (corticosteroid) directly into the eye, as per a study.

This finding was disclosed after a study was conducted by Neil M. Bressler, M.D., of Johns Hopkins University School of Medicine, Baltimore, and colleagues in the Diabetic Retinopathy Clinical Research Network conducted and involved 840 eyes of 693 participants having macular edema.

From Sciencedaily.com:

Corticosteroids have been shown to interfere with the creation of new blood vessels, possibly by reducing the production of compounds that spur their growth, the authors note. However, steroids are also associated with other eye diseases.

“Use of this intravitreal [injected into the eye] corticosteroid preparation to reduce the likelihood of progression of retinopathy is not warranted at this time because of the increased risk of glaucoma and cataract associated with intravitreal steroid use,” the authors write. “Any treatment to be used routinely to prevent proliferative diabetic retinopathy likely needs to be relatively safe because the condition already can be treated successfully and safely with panretinal photocoagulation. Nevertheless, further investigation with regard to the role of pharmacotherapy for reduction of the incidence of progression of retinopathy appears to be warranted.”

The finding appeared in the December issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Tags: corticosteroid, Diabetic retinopathy, steroid use, steroids, triamcinolone

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Individuals who are prone to allergies could find some relief coming their way since the springtime mountain cedars and tree pollens have generally subsided as summertime is here.

Reducing exposure to outdoor venues during peak times, air conditioning, wearing masks, and closing the windows can be some of the strategies adopted by individuals for avoiding allergies, according to Dr. David Khan, associate professor of internal medicine at UT Southwestern Medical Center.

From Sciencedaily.com:

Prescription antihistamines can offer more potency and be less sedating than over-the-counter measures, Dr. Khan said.

Corticosteroid anti-inflammatory nasal sprays can be used regularly, often once a day, and are generally safe and effective. These are not the same as anabolic steroids that athletes sometimes abuse and for which some school systems now test.

Antihistamines, decongestants and corticosteroids, however, do no more than depress symptoms. “Although you’ll be reducing the effect of the allergic reaction, you’ll still be just as allergic at the end of the day,” Dr. Khan said.

Shots are the most effective medical treatment, he said, actually making allergy sufferers less allergic.

Despite the fact that pollen quantity in the air is not influenced by heat, it has the ability of stimulating the formation of ground-level ozone that can exacerbate allergy symptoms.

Tags: anabolic steroids, antihistamines, corticosteroid

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A research has suggested that fluticasone propionate (Flonase), a corticosteroid nasal spray, is superior to a combination of popular anti-allergy drugs loratidine (Claritin) and montelukast (Singulair) for managing seasonal allergies.

It was remarked by Robert Naclerio, M.D., professor of surgery at the University of Chicago and director of the study that inflammation measures were significantly better for patients afflicted with hay fever and treated with fluticasone propionate.

From News.Bio-Medicine.Org:

“Because of the effect on inflammation, we prefer fluticasone,” he added, “but for patients, the choice may come down to cost and whether they would prefer a pill or a spray.”

Since one out of five people in the United States suffers from seasonal allergies, such preferences have financial implications. Antihistamines are prescribed three times as often, even though intranasal corticosteroids are less expensive than the non-sedating antihistamines. Combining loratidine with montelukast increases the cost difference.

A daily dose of Claritin, the leading antihistamine, costs $2.92 at the University of Chicago Hospitals pharmacy. Singulair, which works by blocking leukotrienes — substances that trigger inflammation — costs $4 per day. Flonase, the leading prescription nasal spray, costs $2.21 per day.

This finding by researchers from University of Chicago was presented at the 58th annual meeting of the American Academy of Allergy, Asthma and Immunology.

Tags: corticosteroid, corticosteroids, fluticasone propionate, hay fever

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According to a new study by researchers at Washington University School of Medicine and other institutions, young children with asthma can be treated in a better way by increasing doses of steroids or adding more drugs to the asthma therapy.

Results of this study have implications to help medical practitioners to predict which all of the available treatment options will help their patients the most.

Robert C. Strunk, M.D., and Leonard B. Bacharier, M.D., both Washington University pediatric asthma specialists at St. Louis Children’s Hospital were co-authors for this study.

From Sciencedaily.com:

“We used a few complicated and expensive tests we thought would help us determine which drug would be better, but they didn’t help, so we can avoid these tests,” says Strunk, the Donald Strominger Professor of Pediatrics at Washington University School of Medicine.

Although 98 percent of patients in the study showed improvement on at least one of the step-up options, there were still 120 asthma exacerbations, or attacks, among the 165 patients that required treatment with prednisone, a corticosteroid commonly used after an exacerbation that prevents the release of inflammatory substances in the body. Bacharier says that indicates none of these treatments provide perfect asthma control.

“There may not be an ideal therapy for every patient, but these step-up treatments allow for improved asthma control and outcomes over leaving them on low-dose steroids alone,” Bacharier says.

The study was published online March 2, 2010, by the New England Journal of Medicine and presented the same day at the American Academy of Allergy, Asthma and Immunology’s annual meeting in New Orleans.

Tags: Asthma, asthma therapy, corticosteroid, Prednisone, steroids

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The possibility of increased incidence of rejection and reduced incidence of glucose intolerance necessitating treatment for diabetes is linked with early steroid withdrawal after liver transplantation, as per a recently concluded study.

This finding was disclosed in the first double-blind placebo-controlled study that was aimed at evaluating the effects of early steroid withdrawal.

From News-Medical.Net:

“Although the incidence of acute rejection in the placebo group was increased, it was easily controlled in most of the cases and did not affect long-term graft histology or survival,” the authors note, adding that the increase may ultimately be acceptable if steroids could be eliminated. However, the main goal of steroid elimination is to reduce metabolic complications and this study showed no difference in cholesterol or hypertension, with a trend toward a decreased incidence of diabetes in the placebo group.

The authors conclude: “Indeed, while there are many arguments in favor of corticosteroid withdrawal beyond 3 months posttransplantation, in terms of safety and efficacy, our study demonstrates that earlier withdrawal at day 14 is not completely safe in terms of rejection, but seems efficient in terms of improvement of glucose tolerability,” which could decrease long-term mortality due to cardiovascular disease.

The study was published in an issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS).

Tags: corticosteroid, early steroid elimination, early steroid withdrawal, steroid

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Scientists from the Royal Hallamshire Hospital, Sheffied, UK, have discovered that many ‘herbal creams‘ for eczema contain steroid, which may lead to permanent damages in patients using these creams.

Discovery of eczema creams labeled as ‘herbal’ actually contained steroids was prompted by a call from the scientists for stringent regulations.

From MedicalNewsToday.com:

Eczema can be controlled by using corticosteroid creams (prescription only). However, many people do not like them because of their long-term effects (there can be permanent skin damage, growth retardation in children and hormonal disruption during milestones of a child’s development).

As a result, many people have resorted to herbal medicines.

Dr. Helen Ramsay (Royal Hallamshire Hospital, Sheffied, UK) has said that patients are getting steroids from ‘natural, herbal products‘.

They tested 24 creams and found that 20 of them had ‘powerful, or very powerful steroid drugs‘ (in varying concentrations).

One product called ‘Wau Wau’ was found to be a pharmaceutical steroid brand mixed in a paraffin base. The instructions on the packet told the patient to apply it all over – there was no minimum age. If a parent followed the instruction on their 4-year-old, the child would be receiving 135 grams a week of cream. The child would be exposed to dangerous levels of steroids.

The researchers also found that these creams were more expensive than standard prescription charges (in the UK).

This is an unfortunate state of affairs. Three years ago a similar study found 80% of natural creams had power steroids in them. So, no progress at all has been made to protect patients.

The scientists found varying concentrations of steroid drugs in 20 out of 24 tested creams.

Tags: corticosteroid, eczema, herbal creams, Steroid drugs, steroids

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People suffering from allergies may have experienced respite with springtime mountain cedars and tree pollens subsiding but summer times are here and this may mean trouble again.

However, allergy suffers can avoid allergies to a significant extent by putting a limit on outdoor exposure during peak times, closing the windows, air conditioning, and mask wearing, according to Dr. David Khan, associate professor of internal medicine at UT Southwestern Medical Center.

From Sciencedaily.com:

Prescription antihistamines can offer more potency and be less sedating than over-the-counter measures, Dr. Khan said.

Corticosteroid anti-inflammatory nasal sprays can be used regularly, often once a day, and are generally safe and effective. These are not the same as anabolic steroids that athletes sometimes abuse and for which some school systems now test.

Antihistamines, decongestants and corticosteroids, however, do no more than depress symptoms. “Although you’ll be reducing the effect of the allergic reaction, you’ll still be just as allergic at the end of the day,” Dr. Khan said.

Shots are the most effective medical treatment, he said, actually making allergy sufferers less allergic.

It is worth nothing here that though heat doesn’t influence amount of pollen in the air but it does stimulate the formation of ground-level ozone, which could exacerbate symptoms of allergy.

Tags: allergy, anabolic steroids, antihistamines, corticosteroid, corticosteroids, steroids

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