According to a review of studies comparing inhaled corticosteroids and cromolyn, it was noted that adults and children suffering from asthma and using inhaled corticosteroids fared better than those using cromolyn.

James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues, said that patients on steroids had on average three fewer severe asthma flare-ups each year, scored better on lung function tests, and make lesser use of inhalers than their counterparts on cromolyn.

From News-Medical.Net:

“Any expert would agree that inhaled corticosteroids are preferred first-line therapy for treatment of persistent asthma, which requires daily therapy. But we also will agree with the NIH [National Institutes of Health] asthma guidelines, which state that cromolyn and other drugs are alternative therapies,” Storms said.

Cromolyn, or sodium cromoglycate, and inhaled corticosteroids both block the action of certain inflammatory cells in the lungs. Physicians recommend both types of medication for persistent asthma, but individual studies disagree about which type of medication works best, the reviewers found.

“The safety of sodium cromoglycate has been well established, but the effectiveness of sodium cromoglycate in controlling asthma symptoms may be limited,” Guevara said, adding that the lack of effective control might be one reason cromolyn has fallen out of favor compared to inhaled corticosteroids since the 1990s.

William Storms, M.D., an allergist at the University of Colorado Health Sciences Center and director of the William Storms Allergy Clinic in Colorado Springs, said that the consensus still provides room for cromolyn treatment.

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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.

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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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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.

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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.

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The largest study of its kind on preschoolers has suggested that high doses of inhaled corticosteroids as preventive treatment is very much effective for minimizing the severity and time duration of asthma attacks, which are triggered by colds.

This 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 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 basic treatment for asthma, which consists of administering weak doses of inhaled steroids such as fluticasone on a daily basis, has not proven to be effective in children with viral-induced asthma. For the purposes of the study, 2243 children were screened. Some 17 percent met the criteria for having asthma that was triggered solely by colds, no signs of allergy and had not experienced moderate to severe asthma attacks or symptoms between colds.

The new therapeutic approach was tested in 129 children aged 12 months to six years. By increasing the usual pediatric dose six-fold over a maximum of 10 days and beginning administration as soon as colds started, the team noted a 50 percent decrease in asthma attacks that required oral steroids in children.

The research team was able to find that high doses of corticosteroids (fluticasone), when administered in an inhaled form up to ten days at the onset of a cold can minimize the count of moderate or severe asthma attacks that require emergency oral steroids.

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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.

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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.

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Some children may face problems while responding to steroid treatment for reducing the occurrence and severity of asthma attacks, as per a new study presented at the American Thoracic Society.

It was remarked by researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston that this study highlighted the fact that not all children react to inhaled corticosteroids in the same manner.

From News-Medical.Net:

“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”

The data comes from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years. “This study gives us a good sense of real-world practice in asthma management,” Dr. Sawicki says. “The children’s care is not directed by anyone in the study; it’s an observation of what goes on when the children’s care is directed by their own physicians.”

Sawicki was of the view that even higher dosages of inhaled steroids may not solve the purpose for controlling asthma in an effective way, a fact that has also been suggested by past studies on asthma treatment.

It is considered that results of this study would prove beneficial in developing and implementing an improved asthma treatment option, especially in cases without any positive results in the past.

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Asthmatic children and adults can exercise a better control over asthma and breathe deeper, as per a new review of recently concluded studies comparing inhaled corticosteroids and the medicine cromolyn.

James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues were of the view that patients suffering from asthma and treated with steroids enjoy an advantage of scoring higher in lung function tests. It was remarked that the use of inhaled corticosteroids help asthmatic patients to make lesser use of inhalers than patients who makes use of cromolyn.

From News-Medical.Net:

“To our knowledge, this is the first systematic review comparing the effects of cromolyn to the gold standard, inhaled steroids,” Guevara said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The consensus still leaves room for cromolyn treatment, according to William Storms, M.D., an allergist at the University of Colorado Health Sciences Center and director of the William Storms Allergy Clinic in Colorado Springs.

“Any expert would agree that inhaled corticosteroids are preferred first-line therapy for treatment of persistent asthma, which requires daily therapy. But we also will agree with the NIH [National Institutes of Health] asthma guidelines, which state that cromolyn and other drugs are alternative therapies,” Storms said.

Cromolyn, or sodium cromoglycate, and inhaled corticosteroids both block the action of certain inflammatory cells in the lungs. Physicians recommend both types of medication for persistent asthma, but individual studies disagree about which type of medication works best, the reviewers found.

Guevara and colleagues further remarked that inhaled corticosteroids are any day better than cromolyn irrespective of the severity level of asthma and said that the obtained results are so decisive that there is need to warrant any further studies on this matter.

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