Injecting triamcinolone, the corticosteroid, directly into the eye can possibly slow down the progression of diabetic retinopathy, which is a complication of diabetes that may result in vision loss and blindness.

This finding was presented in a report in the December issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Proliferative diabetic retinopathy is a complication that occurs when new blood vessels form on the optic disc or another retina component.

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 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 a study involving 840 eyes of 693 participants having macular edema.

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In the largest study of its kind on preschoolers, it was noted that high doses of inhaled corticosteroids are effective for minimizing the severity and duration of asthma attacks triggered by colds

The study was published in the New England Journal of Medicine and led by Dr. Francine Ducharme, assistant director of clinical research at the Sainte-Justine Hospital Research Center and a pediatrics professor at the Université de Montréal.

From News-Medical.Net:

The research team found that high doses of corticosteroids (fluticasone), when inhaled at the onset of a cold and taken for up to 10 days, reduces the number of moderate or severe asthma attacks that require emergency oral steroids. This is the first study whose findings clearly demonstrate the treatment’s efficacy in young children requiring oral corticosteroids or hospital admission because of the severity of this type of asthma attack.

The breakthrough is all the more important, since this age group represents more than half (60 percent) of children that go to emergency departments or are admitted to hospital for asthma attacks. Although viral-induced asthma is frequent in preschool-aged children, optimal management of this disease remains elusive. That’s why Dr. Ducharme has focused her research on improving treatment for asthmatic children, particularly those of preschool age

The involved researchers still need to confirm if children can make up for slight growth retardation as the average growth rate of the untreated children was about 6.5 cm as opposed to 6.0 cm in the children treated with fluticasone, the corticosteroid.

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According to a new research, individuals with mild and persistent asthma and administered with twice-daily use of inhaled steroids may make lesser use of inhalers or switch to a new pill.

Stephen P. Peters, M.D., Ph.D., lead author and a professor of pediatrics, internal medicine-pulmonary and associate director of the Center for Human Genomics, remarked that this finding is good news for patients with mild, persistent asthma as it gives them extra choices for asthma management.

From News-Medical.Net:

The study, involving 500 children and adults with mild asthma, was conducted by the American Lung Association’s Asthma Clinical Research Centers. Its goal was to determine if patients whose symptoms are well controlled on twice daily inhaled corticosteroid can “step down” their medication use. The results are reported in the May 17 issue of the New England Journal of Medicine.

Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month. The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms. Patients may also take additional drugs such as the inhaler albuterol, known as “rescue” therapy, to treat symptoms. A majority of people with asthma have mild disease, according to Peters.

The study involved patients whose asthma was treated with twice-daily inhaled fluticasone propionate (Flovent Discus), a commonly prescribed synthetic steroid. This drug is designed to suppress inflammation within the airways that can cause narrowing.

Peters said that it would be best for patients faring well with the twice a day inhaled corticosteroid treatment option and seeking other options to talk to their doctors before making a decision.

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Injecting a corticosteroid, triamcinolone, directly into the eye can slowdown the progression of proliferative diabetic retinopathy, a complication of diabetes that frequently leads to blindness.

This finding was revealed by a team of researchers led by specialists at the Johns Hopkins Wilmer Eye Institute.

It was however noted by the study authors that steroid use in the eye may raise the risks of glaucoma and cataract and laser photo-coagulation remains the treatment of choice till the time a new treatment option is formulated that can reproduce the positive effects of steroids without the associated risks of such use.

From News-Medical.Net:

According to Bressler, lead author of the study, there was some evidence that steroids could improve vision outcomes from diabetic macular edema (DME), swelling of the center of the retina, the part of the retina used for reading or driving. Study results showed that steroids were not superior to laser treatments for DME.

“The primary objective of the study was to determine if steroids were superior to laser for DME, and if so, to balance that superiority with steroids’ side effects. A secondary objective was to determine if the steroids affected the progression of diabetic retinopathy,” adds Bressler. “Steroid treatments did reduce the risk of progression of diabetic retinopathy, but, not DME, which can also cause vision loss from proliferative diabetic retinopathy, bleeding in the middle cavity of the eye or scarring of the retina, which can detach the retina from the back wall of the eye.”

Neil M. Bressler, the James P. Gills Professor of Ophthalmology and chief of the Retina Division of the Johns Hopkins Wilmer Eye Institute, chair of the government-sponsored Diabetic Retinopathy Clinical Research Network, remarked that though steroid treatment works, it cannot be recommended on a routinely basis due to the safety issues.

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A reduced tolerance and higher rejection incidence to glucose can be seen to necessitate diabetes treatment if steroids are withdrawn at an early stage following transplantation of the liver.

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). The finding was highlighted after a first double-blind placebo-controlled study was conducted for examining 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.

It is considered that the study on early steroid withdrawal would help may prove helpful to members of the medical community for handling complicated issues like this one, with a higher sense of caution.

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Repeated courses of a corticosteroid called betamethasone, which is indicated for improving the survival of unborn premature babies, can increase the risks of cerebral palsy in those children.

This finding was disclosed as per results from a multi-center study, funded by the National Institutes of Health and led by Ronald Wapner, M.D., professor of obstetrics and gynecology, Columbia University Medical Center and attending obstetrician and gynecologist at NewYork-Presbyterian Hospital/Columbia.

The study results were published in an issue of the New England Journal of Medicine.

From News-Medical.Net:

In one of the first such trials to examine the long-term effects of the treatment on the children, women who remained pregnant a week after the initial course of corticosteroids were randomly assigned to weekly courses of corticosteroids or placebo until their babies were born.

The study, performed by members of the NIH-sponsored Maternal-Fetal Medicine Network followed a total of 556 infants at the Morgan Stanley Children’s Hospital of NewYork-Presbyterian Hospital/Columbia and 12 other sites around the country, and found that by ages two to three, the two groups of children were physically and neurologically identical, except that six out of 248 children who received multiple courses of corticosteroids had been diagnosed with cerebral palsy, compared to only 1 out of 238 children in the placebo group. The mothers of all six children with cerebral palsy in the corticosteroid group had received four or more courses of the drug.

It was remarked by Dr. Wapner that since weekly courses had no long-term benefits and may potentially harm the child, medical doctors must not administer multiple weekly courses of corticosteroids.

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Injecting triamcinolone, the corticosteroid, into the eye can slow down the progression of diabetic retinopathy, as per a report in the December issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Diabetic retinopathy is a complication of diabetes that may result in blindness and vision loss.

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.”

This 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.

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According to researchers at the University of Pennsylvania, Vitamin D can slow down the progressive decline in the ability to breathe that can happen to some asthmatic people as a result of human airway smooth muscle (HASM) proliferation.

It was found that calcitriol, which is a form of vitamin D synthesized within the body, minimizes growth-factor-induced HASM proliferation in cells that are isolated from people affected by asthma and even those not affected by the ailment.

From Sciencedaily.com:

The experiments were conducted with cells from 12 subjects, and the researchers compared calcitriol with dexmethasone, a corticosteroid prescribed widely for the treatment of asthma. Although, dexmethasone is also a powerful anti-inflammatory agent, the researchers found that it had little effect on HASM growth.

Dr. Damera and his colleagues found calcitriol inhibits HASM in a dose-dependent manner, with a maximum inhibitory effect of 60 percent ± 3 percent at 100nM.

As part of the University of Pennsylvania’s Airway Biology Initiative, the researchers are planning a randomized control trial of calcitriol in patients with severe asthma and expect to have data from the trial in about a year’s time.

Gautam Damera, Ph.D., who will present the research at the American Thoracic Society’s 105th International Conference in San Diego, remarked that calcitriol has the potential of delivering dramatic results because f its anti-inflammatory characteristics.

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According to a new review, chronic asthma patients can have a new treatment option allowing them to manage their ailment in an effective manner with a single prescribed inhaler that contains two medicines.

In the recent past, researchers have been examining the usage of both beta2-agonist (formoterol) and a low-dose corticosteroid (budesonide) in a single inhaler and this review evaluated the new inhaler’s effectiveness.

From News-Medical.Net:

“Encouraging people to use their preventive medication is important, as it is often the case that people with asthma default on their inhaled corticosteroids,” said lead reviewer Christopher Cates, M.D., at the Community Health Sciences of St. George’s at the University of London. “This is partly because inhaled steroids do not make an immediate difference to asthma symptoms.”

In most studies, participants had treatment with a single inhaler - one inhalation of 80/4.5 milligrams of budesonide/formoterol twice daily, and as needed. Patients in the control groups used their prescribed inhaled corticosteroid with a separate reliever inhaler. Cates and his colleague evaluated three studies that included more than 4,200 adults and adolescents with chronic asthma. One study also included 224 children.

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

Carlos Camargo, M.D., an associate professor of medicine at Harvard Medical School, remarked that the single-inhaler therapy is a new approach to chronic asthma treatment that works but requires further study.

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Researchers led by specialists at the Johns Hopkins Wilmer Eye Institute have been able to found out that injecting triamcinolone, a corticosteroid, directly into the human eye can slow the progression of proliferative diabetic retinopathy, a complication of diabetes that results in blindness.

It was, however, remarked that use of steroids may lead to an increased risk of glaucoma and cataract. Laser photocoagulation is the best treatment option till the time a new drug is not discovered that can offer the good effects of steroids, minus the damage.

From News-Medical.Net:

“Steroid treatment worked, but because of safety issues, cannot be recommended routinely at this time,” says Neil M. Bressler, the James P. Gills Professor of Ophthalmology and chief of the Retina Division of the Johns Hopkins Wilmer Eye Institute, chair of the government-sponsored Diabetic Retinopathy Clinical Research Network. “It is a condition that can be treated safely and effectively with lasers.”

The study, published in the December issue of the Archives of Ophthalmology, described and compared one of two treatments on 840 eyes from 693 men and women between July 2004 and May 2006. The subjects, about evenly divided between men and women with an average age of 63, had diabetic retinopathy with macular edema, a swelling of the central portion of the retina that’s caused by leakage of fluid.

Proliferative diabetic retinopathy is marked by the growth of new and unwanted blood vessels on the optic nerve in the back of the eye (which communicates information from the retina to the brain) or another area of the retina, the light-sensitive part of the eye. Despite advances in treating both diabetes and its complications, about 700,000 Americans have proliferative diabetic retinopathy and 63,000 new cases develop each year.

According to Bressler, lead author of the study, there were some evidences that suggest steroids can enhance vision outcomes from diabetic macular edema (DME).

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