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Friday 11, Nov 2011

  Post-transplant Fracture Risk reduced with early steroid withdrawal

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Patients who receive kidney transplants who are withdrawn from corticosteroid-based immunosuppression (CSBI) as early as possible after transplantation have significantly lower fracture rates compared with patients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

The study was supported by the Doris Duke Charitable Foundation.

Saturday 27, Aug 2011

  Young boys with muscular dystrophy helped by daily steroids

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Young boys with muscular dystrophy helped by daily steroids Young boys with Duchenne muscular dystrophy are able to walk on their own for longer period of time when they receive daily steroid treatments for several years.

Daily steroid treatment also helps them reduce the risk of scoliosis, according to a study published in an issue of Neurology®, the scientific journal of the American Academy of Neurology.

“Previous studies have shown steroids improve strength and function in Duchenne muscular dystrophy, but this is the first study to show the long-term impact and how treated boys are able to walk longer on their own,” said study author Wendy King, PT, with the Department of Neurology at Ohio State University Medical Center, and member of the American Academy of Neurology.

Tuesday 22, Feb 2011

  Morbidity and mortality of severe bacterial pneumonia reduced by steroids

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Morbidity and mortality of severe bacterial pneumonia reduced by steroidsThe use of corticosteroids is effective for reducing the morbidity and mortality of severe bacterial pneumonia, Dr. Antoni Torres said at the 12th International Congress on Infectious Diseases.

The finding was supported by results from two positive randomized trials, multiple observational studies, and animal models.

The first randomized trial was a multicenter, double-blind, Italian study involving 46 patients with severe CAP on placebo or 200 mg of hydrocortisone as an IV bolus, followed by 7 days of therapy at 10 mg/hour.

Sunday 06, Feb 2011

  Exacerbation rate in COPD reduced by Roflumilast

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Exacerbation rate in COPD reduced by RoflumilastIn a large 12-month randomized trial, Roflumilast was found effective for improving lung function and prevent exacerbations in patients with COPD with chronic bronchitis and severe airflow obstruction.

Dr. Andrew McIvor said at the annual meeting of the American College of Chest Physicians that results of the 1,568-patient, double-blind, placebo-controlled study known as the M2-125 trial indicate that roflumilast is an important potential advance in the treatment of a subset of patients with COPD.

Dr. McIvor of St. Joseph’s Healthcare Hamilton (Ont.) explained that Roflumilast (Daxas) is an investigational selective phosphodiesterase 4 inhibitor that can target the inflammation that is a hallmark of the disease when taken daily in an oral form.

Saturday 05, Feb 2011

  Off-label use of Tacrolimus and Pimecrolimus on increase

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Off-label use of Tacrolimus and Pimecrolimus on increaseThomas A. Luger, M.D., said at a satellite symposium held in conjunction with the annual meeting of the European Society for Dermatological Research that the topical calcineurin inhibitors constitute the most important advance in topical therapy of inflammatory dermatoses in half a century.

Dr. Luger, professor and chair of dermatology at the University of Münster (Germany) added, “I think that this is the first new and effective development in topical therapy since Marion Sulzberger introduced the corticosteroids for treatment of inflammatory skin diseases 50 years ago.”

Dr. Luger said at the satellite symposium sponsored by Novartis that there are some skin diseases where the early off-label clinical experience with the topical calcineurin inhibitors appears to be favorable but randomized controlled trials will be required to establish which patients are best treated with these agents.

Thursday 03, Feb 2011

  Low doses of steroids cut septic shock mortality

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Low doses of steroids cut septic shock mortalityDr. Djillali Annane said at the 12th International Congress on Infectious Diseases that a consensus has emerged that corticosteroids provide major benefits in patients with severe sepsis or septic shock.

Dr. Annane of the University of Versailles, France, said these benefits only with low doses of corticosteroids administered for at least 5 days, and only in the sizable patient subsets having adrenal insufficiency or refractory septic shock.

From Internalmedicinenews.com:

Much of the lengthy controversy in this field was the result of great heterogeneity in clinical trials, particularly those done before 1992. For example, steroids for septic shock fell into disfavor all through the 1980s and 1990s because multiple trials before 1992 showed no benefit. That’s because these negative studies used short-course, high-dose corticosteroids, Dr. Annane explained. Today, with the benefit of hindsight, it can be emphatically stated that no evidence supports the use of such therapy, he said at the congress, which was sponsored by the International Society for Infectious Diseases.

Dr. Annane was first author of a 2006 Cochrane Collaboration systematic review of corticosteroids for treatment of severe sepsis and septic shock (Cochrane Library ISSN 1464-780X).

In 15 randomized trials totaling more than 2,000 children and adults included in the analysis, steroid therapy didn’t change 28-day all-cause mortality. But the results varied with dosing strategy. In nine trials of replacement-dose corticosteroids—the equivalent of hydrocortisone at 200–300 mg/day intravenously for 5 days or longer—there was a highly significant 20% reduction in the relative risk of 28-day mortality compared with placebo, along with a greater proportion of patients experiencing shock reversal by day 7. In contrast, patients on high-dose, short-course corticosteroids didn’t benefit.

The benefits, as shown in multiple randomized placebo-controlled trials, are enhanced 28-day mortality, shorter shock duration, improved hemodynamics, reduced organ dysfunction, and less systemic inflammation.

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).

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.

Saturday 13, Nov 2010

  Most sore throat patients do not need steroids

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Most sore throat patients do not need steroidsAccording to a new review of studies, most individuals afflicted with sore throat don’t need to ask their doctors for steroids such as prednisone.

Study co-author Dr. Brian H. Rowe of the University of Alberta in Edmonton told Reuters Health that there has been “a bit of a push” for using corticosteroids to treat sore throats based on the inflammation-quelling powers of the drugs.

Rowe said that steroids work fast for known strep throat but their benefits aren’t enough to justify widespread use to treat sore throat.

Tuesday 14, Sep 2010

  Overweight or obesity reduce response to steroids

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Overweight or obesity reduce response to steroidsBeing overweight or obese does not make asthma worse in patients with mild and moderate forms of the health complication, as per researchers from National Jewish Health. It was, however, noted by the researchers that it could minimize the response to medications.

Lead author E. Rand Sutherland, Associate Professor of Medicine at National Jewish Health said that the findings suggest that asthma improvement may not necessarily result from loss of weight.

Dr. Sutherland said the data suggest that obese and overweight people respond less well to asthma controller medications when compared to their leaner counterparts.

Wednesday 08, Sep 2010

  Biological rationale behind success of steroids to treat lupus explained

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Biological rationale behind success of steroids to treat lupus explainedThe biological rationale for why large doses of corticosteroids given repeatedly over several weeks may help individuals with lupus has been uncovered by researchers at UT Southwestern Medical Center.

Lupus is a chronic inflammatory disease that affects more than 1 million people in the United States. Unlike the anabolic steroids abused by athletes for bulking up muscles, corticosteroids are routinely used to treat inflammation in lupus patients.

Dr. Marilynn Punaro, professor of pediatrics at UT Southwestern and co-author of the study and director of the pediatric rheumatology division at UT Southwestern, said that steroids are probably always going to be a short-term fix because they work fast and powerfully.

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