According to a study, women who are pregnant and suffering from asthma can use inhaled steroids without worrying about steroids affecting the growth of their babies.

It was disclosed by the involved researchers that the baby is in more danger of oxygen deprivation than his/her 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.

The results of this study appeared in the Journal of Allergy and Clinical Immunology.

Tags: Asthma, Inhaled steroids, steroids

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The use of steroids (corticosteroids) in association with the risk of cataract was recently examined by a study conducted by the Centre for Vision Research, University of Sydney, Australia.

This population-based study, a cohort of the Blue Mountains Eye Study, examined 3,654 Australians, aged 49 years or older, five and 10 years after initial (baseline) examinations were conducted between 1992 and 1994.

From Medicalnewstoday.com:

Elevated cataract risks were found only in patients who, at the time of their baseline exams, had ever used inhaled steroids, had also used oral steroids for at least one month, and had no cataracts. Patients at highest risk for two types of cataract were those defined at baseline as “current users” of both steroid forms; although this was a small group, follow up exams found that nearly all of them developed cataracts. Of seven current user patients, five had used either steroid form for more than five years, and four of the five developed posterior subcapsular cataract (PSC). Three additional current user patients developed nuclear cataracts. In nuclear cataracts the center of the lens is obscured, and in PSC the cataract develops in the rear area of the lens. Earlier research had established a higher risk for PSC in oral steroids users.

It was remarked by lead researcher, Jie Jin Wang, MMed, PhD, Centre for Vision Research that combined use of steroids in cumulatively high doses could raise risks for two types of cataract.

Tags: cataract, corticosteroids, Inhaled steroids, Oral Steroids, steroids

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Low vitamin D levels share a relationship with lower lung function and greater medication use in children affected with asthma, as per researchers at National Jewish Health in a paper published online in the Journal of Allergy & Clinical Immunology.

It was reported by Daniel Searing, MD, and his colleagues that vitamin D has the ability to improve the activity of corticosteroids, which are considered to be the most effective of all asthma control medications.

From Sciencedaily.com:

Patients low in vitamin D generally had higher levels of IgE, a marker of allergy, and responded positively to more allergens in a skin prick test. Allergies to the specific indoor allergens, dog and house dust mite, were higher in patients with low vitamin D levels. Low vitamin D also correlated with low FEV1, the amount of air a person can exhale in one second, and lower FEV1/FVC, another measure of lung function. Use of inhaled steroids, oral steroids and long-acting beta agonists were all higher in patients low in vitamin D.

“Our findings suggest two possible explanations,” said senior author Donald Leung, MD, PhD. “It could be that lower vitamin D levels contribute to increasing asthma severity, which requires more corticosteroid therapy. Or, it may be that vitamin D directly affects steroid activity, and that low levels of vitamin D make the steroids less effective, thus requiring more medication for the same effect.”

The researchers performed a series of laboratory experiments that indicated vitamin D enhances the action of corticosteroids. They cultured some immune cells with the corticosteroid dexamethasone alone and others with vitamin D first, then dexamethasone. The vitamin D significantly increased the effectiveness of dexamethasone. In one experiment vitamin D and dexamethasone together were more effective than 10 times as much dexamethasone alone.

Dr. Leung said that the work suggested that vitamin D improves the anti-inflammatory function of corticosteroids.

Tags: Asthma, corticosteroids, dexamethasone, Inhaled steroids, Oral Steroids, steroids, Vitamin D

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Medical practitioners generally recommend inhaled steroids to patients affected by Chronic Obstructive Pulmonary Disease (COPD) but a study has found out that these anti-inflammatory drugs could increase the risk of pneumonia.

It was remarked by the researchers that present inhaled corticosteroid use was linked with a significant 70 percent increase in the risk of being hospitalization for pneumonia. This remark came after evaluating a large cohort of patients with COPD.

From Sciencedaily.com:

Pierre Ernst, M.D., a clinical epidemiologist at McGill University, Canada, along with three other researchers from the university’s department of medicine, analyzed the hospitalization and drug prescription information from 1988 to 2003 of 175,906 patients with COPD living in Quebec, Canada. During that time, 23,942 of the patients were hospitalized for pneumonia.

In their report, the researchers noted that the admission rate for pneumonia increased with higher doses of inhaled steroids and that reduction in risk was observed once the medications were stopped. Among all patients taking inhaled steroids, there was a 53 percent increase in pneumonia deaths within 30 days of being admitted to the hospital.

The investigators noted that these findings are particularly relevant, given that pneumonia is the third leading cause of hospitalization in the United States and that inhaled corticosteroid use among patients with COPD increased from 13.2 to 41.4 percent from 1987 to 1995.

These findings were reported in the second issue of the July American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Tags: chronic obstructive pulmonary disease, COPD, Inhaled steroids, steroids

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A new drug, RPL554, was recently found to be effective in treating asthma and hay fever and is about to undergo trials in humans.

The drug, apparently, has the capability of effectively treating respiratory diseases and is without side effects that are regular features with many of the presently available drugs.

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.

Dr. Clive Page, chairman of Verona Pharma, which is developing the treatment, said that the company is also evaluating other novel compounds for tackling respiratory diseases based on anti-inflammatory substances found in starfish and a treatment for coughs.

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

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According to a new study presented at the American Thoracic Society, some children suffering from asthma may find it difficult to keep their asthma under control with inhaled corticosteroids.

In a study of 914 children with mild to severe asthma, it was found that children who reported consistent use of inhaled steroids were 20 percent less likely to report having well-controlled asthma compared with those not using any 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.”

Researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston said that some children may be genetically less responsive than others to steroids.

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 a period of 10 years.

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

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Researchers examining inhaled steroids and children suffering from asthma, as well as asthma and obesity have presented their findings from the National Heart, Lung, and Blood Institute (NHLBI) Asthma Clinical Research Networks at the American Thoracic Society 2007 International Conference in San Francisco.

Wayne Morgan, M.D., of the University of Arizona Health Sciences Center in Tucson, presented new data at the ATS meeting, said that asthma can be controlled but cannot be eliminated.

From Sciencedaily.com:

A second presentation on the PEAK study looked at whether there are ways to predict which high-risk children will do poorly with their asthma. “Some children outgrow their asthma and some maintain their asthma, and PEAK found that inhaled steroids didn’t change that course. However, these high-risk children do respond to inhaled steroids, but if you take them off, they tend to do worse,” says researcher Theresa Guilbert, M.D., Assistant Professor of Pediatrics at the University of Wisconsin-Madison and lead author of The New England Journal of Medicine article. “We know that if children have certain characteristics such if they’re male, have allergy, or have eczema that they tend to do poorly over time.”

A third study from NHLBI’s Asthma Clinical Research Network looked at the impact of overweight and obesity on asthma severity and response to asthma therapy. The study used data from the NHLBI on approximately 1,200 people with asthma.

“This type of study provides extremely rich data in terms of the participants’ height, weight and asthma severity, allowing us to more precisely evaluate the relationship between body mass and asthma severity,” says researcher E. Rand Sutherland, M.D., M.P.H., Assistant Professor of Medicine at the National Jewish Medical and Research Center in Denver. “We can also look at how obesity modifies the response to therapy.”

Two of these presentations consisted of new research findings from the Prevention of Early Asthma in Kids (PEAK) study, which is examining the effect of inhaled corticosteroid therapy on asthmatic children.

Tags: Asthma, corticosteroid, Inhaled steroids, steroids

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A recent study of elderly people at John Hopkins found that many of them have either moderate or severe asthma, which has been under-diagnosed or unattended.

Karen Huss, DNSc, RN, a nurse researcher and associate professor at The Johns Hopkins University School of Nursing, said asthma can result in reduced quality of life for elderly people.

From Sciencedaily.com:

The study indicates that asthma in the elderly also contributes to a decreased quality of life. Those with more severe asthma reported more negative feelings about life in general, described their health as being poor, and had a greater degree of impairment during daily activities. This finding implies that senior citizens with severe asthma are less likely to engage in domestic activities such as dusting and vacuuming, leading to higher allergen levels and ultimately exacerbating severe asthma.

Despite the high levels of allergy Huss found among the elderly, few were taking proper medication to treat it. One third of the elderly in the study were not taking inhaled steroids, the preferred method of treating asthma. Many were using short-acting inhalant medications on a regular basis rather than the recommended way, which is as-needed only.

“It is critical that we first identify and control allergens in an elderly person’s environment in order to avoid asthma attacks,” says Huss. “Skin tests need to be done on elderly patients with asthma so they will know what to avoid. Once allergens in the home are reduced and medications that combat inflammation in the airways are introduced, then asthma severity in the elderly should decrease and the quality of life should improve.”

The study was supported by the Fund for Geriatric Medicine and Nursing of The Johns Hopkins University and by Greer Laboratories, Inc. Other authors were P.L. Naumann, MSN; P.J. Mason, MSN; P.P. Nanda, MPH; R.W. Huss, M.D., C.M. Smith, BS; and R.G. Hamilton, PhD.

Tags: Asthma, Inhaled steroids, severe asthma, steroids

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Pregnant women carrying a girl child and suffering from asthma are at an increased risk of experiencing worsening asthma symptoms than pregnant women carrying a boy child, as per a study presented at the American Thoracic Society International Conference in Orlando on May 25.

Lead researcher Peter G. Gibson, M.D., said that while the reason behind this difference is still unknown, it may be because the female fetus can produce a substance in response to asthmatic mother’s airway inflammation leading to worsening of asthma.

From News-Bio-Medicine-Org:

The study followed 151 pregnant women; 33 did not have asthma, 38 had asthma but did not use inhaled steroids during pregnancy, and 80 had asthma and used inhaled steroids every day during their pregnancy. Steroids control the inflammation of the airways that occurs in asthma. “Inhaled steroids are generally considered safer for the fetus than oral steroids,” Dr. Gibson said.

He found that 60% of asthmatic women who were pregnant with a male fetus were symptom-free throughout their pregnancy and did not report nighttime breathing problems from the 18th to the 30th week of pregnancy. In contrast, 61% of asthmatic women pregnant with a female fetus were symptom-free at 18 weeks, but at 30 weeks only 28% were symptom-free. Nighttime symptoms increased significantly from 18 to 30 weeks in women pregnant with a female fetus.

Use of inhaled steroids increased significantly in asthmatic women pregnant with a female fetus, but did not change in asthmatic women pregnant with a male.

Dr. Gibson, Professor in the Department of Respiratory and Sleep Medicine at Hunter Medical Research Institute at John Hunter Hospital in Newcastle, Australia, remarked that the good news is that asthma among pregnant women can be controlled with asthma treatment.

Tags: Asthma, asthma symptoms, asthma treatment, Inhaled steroids, steroids

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A new treatment option may help people with chronic asthma to manage their condition with a single prescribed inhaler that contains two medicines, as per a review.

Lead reviewer Christopher Cates, M.D., at the Community Health Sciences of St. George’s at the University of London, said that most asthma patients default on inhaled corticosteroids as inhaled steroids do not bring immediate difference to asthma symptoms.

From Sciencedaily.com:

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

However, the reviewers did find that fewer adults on single inhaler therapy had exacerbations needing a course of oral corticosteroids. Compared with 18 people of 100 in the control inhaled corticosteroid group who had an exacerbation treated with oral steroids over 11 months, there were 11 of 100 for the single inhaler therapy group.

“One attraction of the combined inhalers is that the inhaled corticosteroid is automatically taken with the beta-agonist, which does relieve symptoms,” said Cates. “Single-inhaler therapy takes this one stage further, as the inhaled corticosteroid is automatically increased, with the beta-agonist, if the asthma symptoms worsen. This approach shows clear advantages in comparison to taking inhaled corticosteroids alone, but is less convincing when compared to current best practice.”

Carlos Camargo, M.D., an associate professor of medicine at Harvard Medical School, specializes in asthma and chronic obstructive pulmonary disease, remarked that this single-inhaler therapy is an interesting approach to treat chronic asthma.

Tags: Asthma, chronic asthma, chronic obstructive pulmonary disease, corticosteroids, Inhaled steroids, steroids

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