Lung disease experts at Johns Hopkins have advocated for greater caution in prescribing inhaled corticosteroids for COPD (chronic obstructive pulmonary disease) sufferers.

This call for caution came after evidence suggested that inhaled corticosteroids, one of the most widely used anti-inflammatory medications, increase the risk of pneumonia by a full third.

From News-Medical.Net:

“Physicians really need to strongly evaluate a patient’s individual characteristics before prescribing these steroid medications, and patients, in turn, should weigh the risks and benefits of taking the drugs, despite their proven record in providing symptomatic relief,” he says.

According to pulmonologist M. Brad Drummond, M.D., M.H.S., who led the study, “catching this bacterial infection can seriously disrupt quality of life, making it harder for COPD patients to breathe and possibly leading to hospitalization.”

Drummond says the new findings should serve as a reminder to people with the severe lung disease to take steps that reduce the chance of getting pneumonia, which doubles their risk of dying when compared to people with healthy lungs. He also advises COPD sufferers, in addition to weighing the benefits and harms of steroids, to get the pneumonia vaccination every five years and an annual flu vaccination because these shots reduce the chance of getting a lung infection.

Drummond suggested that people suffering from lung disease must take additional precautions such as frequent hand washing to ensure that they lead a normal and healthy life. It was also remarked that further research is a must for providing greater relief to COPD sufferers.

This study is expected to provide a great relief to existing 120,000 Americans suffering from COPD, which is expected to become the nation’s third leading cause of death in the United States by the year 2020.

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According to a study by scientists from the UT Southwestern Medical Center, people suffering from pneumonia can recover at a faster pace with a combination of corticosteroids and traditional antimicrobial therapy than with antibiotics alone.

It is interesting to note here that the unlike the anabolic steroids that are used to bulk up body muscle, corticosteroids are generally used for treating inflammation related to infectious diseases.

From News-Medical.Net:

“Some people might think that if you give steroids, it would counteract the effect of the antibiotic,” said Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author. “But it turns out you need the antibiotic to kill the bug and the steroid to make the inflammation in the lung from the infection get better. The steroids don’t kill the bugs, but they do help restore health.”

Pneumonia is a lung infection typically characterized by breathing difficulties and spread by coughing and sneezing. Symptoms include headache, fever, chills, coughs, chest pain, sore throat and nausea. Pneumonia caused by the Mycoplasma pneumoniae bacterium is generally a less severe form of the disease that can occur in any age group. It accounts for 20 percent to 30 percent of all community-acquired pneumonia cases.

Dr. Hardy remarked that the group that received both the steroids and antibiotics did the best.

Other researchers from the UT Southwestern included Dr. Christine Salvatore, infectious-disease fellow in pediatrics; Dr. Chonnamet Techasaensiri, postdoctoral trainee in pediatrics; Dr. Asunción Mejías, assistant professor of pediatrics; Dr. Juan Torres, visiting senior researcher in pediatrics; Kathy Katz, senior research associate in pediatrics; and Dr. Ana Maria Gomez, assistant professor of pathology. Some researchers from the University of Milan also contributed to this study.

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According to scientists from the UT Southwestern Medical Center, adding corticosteroids to the traditional antimicrobial therapy can prove to be an effective option when it comes to helping pneumonia patients recover faster than with antibiotics alone.

Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author, said that some people think that if you give steroids, they would counteract the antibiotic’s effect. But the truth is that patients need the antibiotic for killing the big and the steroids to improve the level of lung inflammation. In short, steroids do not actually kill the bug but help in restoring good health.

From Sciencedaily.com:

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection. Up to 20 percent of asthma attacks in children and adults have been shown to be triggered by this bacterium.

Despite the positive findings of this study, Dr. Hardy said that it is still too early to recommend steroids as a standard form of treatment for people suffering from this type of bacterial pneumonia, but the work does support the need for a clinical trial.

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Lung disease experts at Johns Hopkins have made a call for greater caution for prescribing inhaled corticosteroids to people with COPD (chronic obstructive pulmonary disease). This call was made after evidence was found that the widely used anti-inflammatory medications tend to raise the risk of pneumonia by a full third.

It is believed that more than 11 million Americans are living with COPD and a vast majority of this population belongs 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.

According to pulmonologist M. Brad Drummond, M.D., M.H.S., who led the study, these new findings are expected to serve as a reminder to all those people with severe lung disease to plan and take steps that can minimize the chances of getting pneumonia, which doubles their risk of dying.

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According to lung disease experts at Johns Hopkins, there is a great need for caution by physicians in prescribing inhaled corticosteroids for patients with COPD (chronic obstructive pulmonary disease). This finding was revealed after it was found out that anti-inflammatory medications increase the risk of pneumonia by a full third.

It is presently estimated that more than 11 million Americans, most of them former or current smokers, are suffering from COPD that is characterized by the fatal and lung-diminishing conditions of emphysema and chronic bronchitis.

From News-Medical.Net:

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.

“Physicians really need to strongly evaluate a patient’s individual characteristics before prescribing these steroid medications, and patients, in turn, should weigh the risks and benefits of taking the drugs, despite their proven record in providing symptomatic relief,” he says.

According to pulmonologist M. Brad Drummond, M.D., M.H.S., who led the study, “catching this bacterial infection can seriously disrupt quality of life, making it harder for COPD patients to breathe and possibly leading to hospitalization.”

Fan says that COPD is expected to become the third leading cause of death in the United States by 2020, behind heart ailments and cancer and ahead of stroke.

During the study, it was advised that physicians need to exercise a higher sense of caution than what is observed by them nowadays so that inhaled corticosteroids do not pose any danger to health of their patients. For this, patients and their families need to be made aware of the pros and cons of inhaled corticosteroid trearment.

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Prescribing inhaled steroids to COPD patients now comes with a warning from General Physicians (GPs) due to the associated risk of pneumonia.

The Medicines and Healthcare Regulatory Agency, which is regarded as the government’s drug safety watchdog, suggested that steroids are presently introduced much earlier than the present medical guidelines recommend. It was revealed that combining LABA (Long acting β2-agonists) with inhaled steroids does not bring any significant advantages in mild ailments but the risk of pneumonia is increased considerably due to intake of steroids.

From Pulsetoday.co.uk:

The government’s drug safety watchdog, the Medicines and Healthcare Regulatory Agency, suggests steroids ‘are being introduced earlier than current guidelines recommend’.

It says combining LABAs with inhaled steroids has no proven significant benefits in mild disease, but that steroids significantly increase the risk of pneumonia.

NICE guidance, currently under review, says inhaled steroids should be added for severe disease with an FEV1 under 50% and where there are repeated exacerbations.

Combination is better than monotherapy in all trials that have compared the two treat-ments, but the benefit is limited.

Inhaled steroids should be limited to when COPD progresses to severe disease, and never on their own, the MHRA says.

These findings were supported by Dr Steve Holmes, a GP in Shepton Mallet, Somerset and education lead of the General Practice Airways Group, who termed them as ‘very sensible.’

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Pneumonia caused by the Mycoplasma pneumoniae bacterium is generally a less severe form of the disease that can occur in any age group. It is a lung infection typically characterized by breathing difficulties, chest pains, fever, sore throat, nausea and spread by coughing and sneezing.

According to some scientist from UT Southwestern Medical Center adding corticosteroids to traditional antimicrobial therapy might help people with pneumonia recover more quickly than with antibiotics alone.

From Bio-Medicine:

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induce d airway inflammation. The animals were then evaluated after one, three and six days of therapy.

“It turns out that the group that got both the antibiotic and the steroids did the best,” Dr. Hardy said. “The inflammation in their lungs got significantly better.”

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection.

Dr. Hardy said it’s too early to recommend steroids as standard treatment for people with this type of bacterial pneumonia, but the work does support the need for a clinical trial.

Unlike the anabolic steroids used to bulk up muscle, corticosteroids are often used to treat inflammation related to infectious diseases.

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According to scientists from the UT Southwestern Medical Center, adding corticosteroids to the traditional antimicrobial therapy can help pneumonia patients to recover early than persisting with antibiotics alone.

It was remarked by Dr. Robert Hardy, associate professor of internal medicine and pediatrics and the study’s senior author that while antibiotics are required for killing the bug, steroids are imperative for treating inflammation in the lung.

From News-Medical.Net:

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induced airway inflammation. The animals were then evaluated after one, three and six days of therapy.

“It turns out that the group that got both the antibiotic and the steroids did the best,” Dr. Hardy said. “The inflammation in their lungs got significantly better.”

Although antimicrobials remain the primary therapy for M pneumoniae infection, there have been several reports in recent years about physicians adding steroids to the treatment regimen of patients with severe cases, Dr. Hardy said. The problem, he said, is that those were individual case reports.

“They never had a control group, so it was impossible to tell what impact the addition of steroids had on recovery,” he said.

The new findings not only suggest that giving antibiotics with steroids can help individuals with pneumonia get better faster, but also suggest a potentially more effective therapy for someone in the midst of an asthma attack due to M pneumoniae infection. Up to 20 percent of asthma attacks in children and adults have been shown to be triggered by this bacterium.

Dr. Hardy said it’s too early to recommend steroids as standard treatment for people with this type of bacterial pneumonia, but the work does support the need for a clinical trial.

It is being perceived that this can open up the doors of a potentially new and effective therapy for patients in the midst of an asthma attack also, which is caused by M pneumoniae infection.

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Researchers have taken up a study stating that unlike the anabolic steroids, there is another kind of steroids known as corticosteroids which are used to decrease the rate of inflammation caused by a bacterial infection. Everybody stays under the impression that steroids are very harmful and ineffective but after studying its positive results to treat pneumonia proved that it is no more an unsafe option to use.

Scientists have found that using a combination of steroids and antibiotics cured pneumonia to a very high level as compared to the one treated only with antibiotics. there was an immense reduction in the inflammation of lungs when studied on a mice infected with a bacterial pneumonia.

From Science daily:

Adding corticosteroids to traditional antimicrobial therapy might help people with pneumonia recover more quickly than with antibiotics alone, UT Southwestern Medical Center scientists have found.

In the current study, mice infected with the M pneumoniae bacterium were treated daily with a placebo, an antibiotic, a steroid, or a combination of the antibiotic and steroid in order to investigate the effect on M pneumoniae-induced airway inflammation. The animals were then evaluated after one, three and six days of therapy.

Though antimicrobials still remain the primary therapy to cure pneumonia like diseases, still after lot of studies on steroids scientists found the importance of using them as a inflammatory reduction element in the treatment.

Also it was found that that this combination is very effective to patients also suffering from asthma. Although Dr. Hardy, one of the scientists from UT Southwestern Medical Center says it’s too early to decide whether to recommend this since still much work needs to be done by clinical trials.

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Doctor John Haughney of the General Practice Airways Group appealed to all GPs to first discuss the potential of pneumonia, osteoporosis and adrenal suppression with all patients with Chronic Obstructive Pulmonary Disease or COPD.

In the new announcement made by Nationa Health Service, all General Practitioners must look carefully at the risk-benefit of inhaled steroids for COPD since recent study links the drugs with an increased risk of pneumonia.

From Pulse:

GPs should discuss the potential risks of pneumonia, osteoporosis and adrenal suppression with all patients with COPD who might benefit from inhaled steroids, say NHS prescribing advisers.

A new bulletin recommends that GPs should look carefully at the risk-benefit of inhaled steroids for COPD following recent research linking the drugs with an increased risk of pneumonia.

It adds that GPs after another recent study finding anticholinergics were associated with an increased risk of all-cause and cardiovascular mortality should also be a factor in GPs’ treatment decisions.

The bulletin recommends GPs discuss the risk-benefit of inhaled corticosteroids, in particular, with patients.

‘Before adding an inhaled steroid to treatment regimens for patients with COPD, prescribers should consider, and discuss with patients, the potential increased risk of pneumonia, as well as osteoporosis and other side effects,’ it reads.

Dr John Haughney, a GP in East Kilbride and member of the General Practice Airways Group, said GPs should wait for more definitive evidence of the risks of inhaled anticholinergics and steroids before alarming patients unnecessarily.

‘How can I explain this to a patient in a meaningful way? I think this guidance has been written to be truthful academically rather than to provide useful advice for GPs,’ he said.

The recent bulletin suggests that GPs should explain clearly to COPD patients the potential side effects of inhaled anticholinergics and steroid rather than give them alarming advice.

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