Inhaling corticosteroids can elevate chances of being diagnosed with type 2 diabetes, according to investigators from the Jewish General Hospital’s Lady Davis Institute for Medical Research (LDI) in Montreal.

The investigators’ findings suggested that asthmatics and those suffering from chronic obstructive pulmonary disorder (COPD) taking corticosteroids may be at a considerable risk.

From Healthjockey.com:

Dr. Samy Suissa, Director of the Centre for Clinical Epidemiology at the LDI, and lead investigator, highlighted, “These are not insubstantial numbers. Over a large population the absolute numbers of affected people are significant. We recommend that physicians reserve the use of inhaled steroids for the patients who truly benefit from these medications, namely asthmatics, and curb their use in COPD to the few patients for whom they are indicated. In all cases, patients using high doses should be assessed for possible hyperglycemia and the lowest effective dose targeted.”

The study was published in the American Journal of Medicine.

Tags: COPD, corticosteroids, Inhaled steroids

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Some people affected with asthma may not be able to respond in the same way as others to inhaled steroids that are used for long-term asthma control.

The finding was revealed in a medical study released online on Monday in the New England Journal of Medicine.

From Au.ibtimes.com:

The research revealed that “asthma patients who inherited two copies of a particular gene variation were not inclined to respond to steroid inhalers compared to those who posses two copies of the more popular variety of the DNA.”

A report from Reuters mentioned that the discovery shows the way to “more personalized treatments from asthma which is an inflammatory ailment affecting more than 20 million Americans and approximately 300 million people globally.”

The findings were introduced at the European Respiratory Society Congress in Amsterdam.

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Findings of a new study have indicated that patients afflicted with difficult-to-control asthma are often not taking their anti-asthma medication as prescribed by their doctor.

Dr. Liam G. Heaney at Queen’s University of Belfast, Northern Ireland, and colleagues found that about 5 percent of adults with asthma remain difficult to control, with persistent symptoms and frequent flare-ups even with they were prescribed high doses of steroids.

From in.reuters.com:

To find out, Heaney’s group studied 182 patients referred to the Northern Ireland Regional Difficult Asthma Service. Nonadherence to anti-asthma therapy was not suspected as a major issue, and all patients denied not taking their medicine at their first visit to the clinic.

Nonetheless, it was found that 35 percent of these patients had filled no more than half their prescriptions for inhaled steroids, and these patients were more likely to have been hospitalized at least 3 times in the previous year.

Women were most apt to be lax in taking their asthma controller medication as prescribed, the researchers note in the latest issue of the American Journal of Respiratory and Critical Care Medicine.

Among 51 asthma patients who were supposed to be using oral prednisolone, blood tests showed that 45 percent were nonadherent.

Heaney and colleagues concluded that asthma could probably improve substantially if patients emphasize upon regular preventative therapy (as prescribed).

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Cells that could possibly play an important role in some forms of steroid-resistant asthma, a complication of the condition that makes treatment even more challenging, have been identified by researchers at Children’s Hospital of Pittsburgh of UPMC.

Study’s senior author, Jay K. Kolls, MD, chief of the Division of Pediatric Pulmonary Medicine, Allergy and Immunology at Children’s Hospital, remarked that the identification of a lineage of cells called as T Helper Type 17 (Th17) could assist scientists in developing new treatments for exercising a better control on the disease.

From Sciencedaily.com:

More than 22 million Americans (including 9 million children) are diagnosed with asthma, according to the U.S. Centers for Disease Control and Prevention (CDC). As many as 50 percent of them have asthma that can be resistant to steroids, which are intended to reduce lung inflammation during an asthma attack, Dr. Kolls said.

“Asthma is a challenging condition to treat. For many patients, if they take preventive medications regularly, the condition can be controlled and they can lead relatively normal lives,” Dr. Kolls said. “Inhaled steroids are an important treatment for patients to prevent asthma attacks. Unfortunately, some patients have attacks despite the use of inhaled steroids, meaning they don’t respond to steroids or they need such high doses that side effects are experienced.”

The study was published in an issue of the Journal of Immunology.

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A potential drug has been identified and about to undergo trials in humans for treating hay fever and asthma.

The drug, RPL554, apparently has the ability to effectively treat respiratory diseases and does not lead to side effects that are usually common characteristics of many of the currently used medications.

From News-Medical.Net:

Dr. Page who is a professor of pharmacology at King’s College London, says RPL554 is a single molecule that does both jobs and should have fewer side effect profile and he says they are cautiously optimistic that they can develop a treatment where one puff will last all day.

Current treatments for asthma and hay fever sufferers are beta-agonists, which open up the airways, and inhaled steroids, which dampen down the inflammation that causes irritation – they are either taken together or singly.

But they have serious side effects, including possible harm to the cardiovascular system and the ‘shakes’ reported by many patients from excess use.

Experts say little progress has been made recently with alternative, effective and practical treatment options for a wide range of people with asthma and hay fever and by combining anti-inflammatory properties and the ability to overcome airway narrowing in a single long-lasting dose via the nose, RPL554 could offer real hope of a significant breakthrough.

It was remarked by Dr. Clive Page, chairman of Verona Pharma, which is developing the treatment, that his company is also ascertaining other novel compounds to tackle respiratory diseases on the lines of anti-inflammatory substances found in starfish and a treatment for coughs.

Tags: Asthma, hay fever, Inhaled steroids, RPL554, steroids

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Black teenagers are more likely to develop steroid-resistant asthma than their white counterparts, according to a research conducted at the National Jewish Medical and Research Center.

It was disclosed in the study that black asthmatic teens are more likely to be sick and suffer from a higher mortality rate than white teens with asthma.

From News.Bio-Medicine.Org:

“Our results suggest that children with steroid-resistant asthma are more likely to be African-American, to have required treatment with oral steroids at an earlier age and to require larger amounts of oral steroids for only marginal control of their asthma,” said Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

Other recent epidemiological studies have shown that blacks with asthma are sicker and have a higher mortality rate than whites with asthma. Doctors at National Jewish now are trying to determine whether blacks have a more vigorous immune response to airway inflammation–which means that higher doses of steroids must be used to control inflammation–or a poor response to steroids secondary to a genetic resistance to the drugs.

“The theory is that with ongoing airway inflammation you get worsening asthma and diminished steroid sensitivity,” Dr. Spahn said.

This study of 164 teen-agers treated at National Jewish also showed that 25 percent of the group was steroid resistant. Children with less than a 15 percent improvement in lung function following a “burst” of inhaled steroids–high doses over seven days–were considered steroid resistant.

“Twenty-five percent of the kids admitted to National Jewish have steroid-resistant asthma, which is much greater than anyone thought,” Dr. Spahn said.

African-American children are prone to steroid-resistant asthma, according to Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

The study was published in the Journal of Allergy and Clinical Immunology.

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Adults and children afflicted with asthma can exercise better control over the disease with inhaled corticosteroids than with cromolyn, according to a study conducted by James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues.

The researchers made comparisons between inhaled corticosteroids and cromolyn to find the better between the two for providing relief to patients with asthma.

From News.Bio-Medicine.Org:

Cromolyn’s manufacturer has changed several times during the past two decades, which may also explain why the drug’s popularity has waned, Storms said. The succession of companies “did not spend one dollar in research in the past 20 years to study cromolyn. All of the data are old and most are forgotten,” he said.

The Cochrane reviewers examined 17 studies involving 1279 children and eight studies involving 321 adults with asthma. They found no differences in serious side effects between those using the steroids and those using cromolyn, but acknowledge that adverse effects were reported inconsistently.

Guevara and colleagues conclude that inhaled corticosteroids were superior to cromolyn regardless of the severity of the asthma. They suggest the results are so decisive that future studies comparing the two types of drugs “may not be warranted.”

It was revealed by the study that adults and children with asthma and treated with inhaled steroids experienced three fewer severe asthma flare-ups each year on an average and made less use of asthma inhalers when compared to asthma patients treated with cromolyn.

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Asthmatic women who are pregnant can continue using their asthma medications without having a concern about steroids affecting growth of their unborn babies, as per a study.

The involved researchers revealed that unborn babies are in far more danger of oxygen deprivation than the mother making use of inhaled steroids.

From MedicalNewsToday.com:

The researchers looked at 396 pregnant women who took inhaled steroids. It did not have an effect on the growth of the fetus. There was no effect on the baby’s birth weight either.

They also found that inhaled steroids are safer for pregnant women to take than steroid pills. Oral steroids have been shown to slow the fetus’ growth. Oral steroids are also used to treat asthma.

The study was carried out at the Kaiser-Permanente Medical Center in San Diego. The team leader was Michael Schatz.

Schatz said ‘Now, women don’t have to make a choice between their health and the health of the baby. They don’t have to think that making that choice is going to somehow harm the baby.’

You can read about the study in the Journal of Allergy and Clinical Immunology.

7% of pregnant women get asthma to some degree. Some of these women use inhaled steroids. The National Asthma Education and Prevention Program, (part of the Department of Health and Human Services), supports the use of steroids in pregnant women with serious asthma.

The worry asthmatic women have when they are pregnant is that the fetus is deprived of oxygen. This can sometimes lead to retardation, premature birth, low birth weight and even stillbirth.

Results of the study appeared in the Journal of Allergy and Clinical Immunology.

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Some children with asthma may not be able to derive the same benefits with inhaled corticosteroids as other asthmatic children, as per a new study presented at the American Thoracic Society.

It was found in a study of 914 children with mild to severe asthma that children reporting consistent use of inhaled steroids were 20 percent less likely to report having well-managed asthma than those not using any kind of inhaled steroids, over a period of one year.

From News-Medical.Net:

Several studies of adults with asthma have suggested that even rigorous use of inhaled steroids doesn’t lead to well controlled asthma in all adults, Dr. Sawicki noted. “But this issue hasn’t been looked at closely in children,” he said. “Further studies are needed to see what is different about children who don’t respond to steroids, to see if there is a way to predict whether a child will respond to inhaled steroids.”

Of the 914 children in the study, inhaled steroids were recommended for 435 who had persistent asthma, meaning they had symptoms on a regular basis. Among children who weren’t recommended for inhaled steroid treatment, most reported well-controlled asthma. Among those recommended for inhaled steroid treatment, 44% reported consistently using the medicine; 35% said they intermittently used the medicine and 21% said they didn’t use it at all.

“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 were followed for a period of over ten years.

Tags: Asthma, corticosteroids, inhaled corticosteroids, Inhaled steroids, steroids

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According to a study published recently in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine (ACSM), children suffering from asthma and into physical fitness are more likely to exercise a better control on the disease and improve their quality of life.

The results show aerobic training as an effective option for improving cardiopulmonary fitness and reducing daily use of inhaled steroids in children with asthma.

From Medicalnewstoday.com:

Asthmatic children, even with moderate to severe disease, showed significant improvements in their aerobic capacity after the training program and a reduction in exercise induced-bronchoconstriction, which induces breathlessness and is a characteristic response to exercise present in most patients. Daily doses of inhaled steroids were reduced in trained patients by 52 percent, but remained unchanged or increased in the control (untrained) group. When compared to controls, these children also reported a significant improvement in health-related quality of life.

The authors emphasize that training should be supervised and performed in children properly medicated, and the actual impact of physical training on clinical indicators of disease control is unknown. While these data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease, additional research is warranted to discover the contribution of exercise on asthma symptoms and its manifestations.

Celso Carvalho, Ph.D., an author on the study, said physical training can be a management strategy for symptoms of asthma in children.

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