There is no difference in terms of major disease factors among patients suffering from cystic fibrosis (CF) receiving inhaled corticosteroids and those who do not.
Disease factors consist of the number of prescribed antibiotics, lung function decline, and onset time of acute chest exacerbation or frequency of using a bronchodilator.
“Oral corticosteroids slow the progression of CF lung disease, but long-term use is precluded by unacceptable side effects,” said Dr. Balfour-Lynn. “A systematic review of inhaled corticosteroid use in CF revealed 10 randomized controlled trials, with six having been published. The trials studied 293 adults and children. Although there was variable methodological quality among the studies, the conclusion was that there was ‘no evidence from existing trials to support the practice of prescribing inhaled steroids in cystic fibrosis.’”
The authors noted that 52 percent of the patients were on high-dose inhaledcorticosteroids (1,000 micrograms or more per day). At those levels, the drug can lead to significant symptoms related to adrenal suppression and insufficiency. Also, among pediatric patients, slowing of linear growth has been a problem for individuals taking the drug for a year or more.
Ian M. Balfour-Lynn, M.D., F.R.C.P., of the Department of Pediatric Respiratory Medicine at Royal Brompton Hospital in London, and six associates, concluded that patients can stop making the use of inhaled corticosteroids for reducing drug burden and to reduce potential adverse side effects.
Individuals suffering from chronic asthma are likely to benefit from a new treatment option that can help them manage their health effectively with a single prescribed inhaler including two medicines, as per a new review.
The involved researchers were studying the effectiveness of both a low-dose corticosteroid (budesonide) and beta2-agonist (formoterol) in a single inhaler.
The review appeared in an issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization evaluating research in all health care aspects.
“Encouraging people to use their preventive medication is important, as it is often the case that people with asthma default on their inhaled corticosteroids,” said lead reviewer Christopher Cates, M.D., at the Community Health Sciences of St. George’s at the University of London. “This is partly because inhaled steroids do not make an immediate difference to asthma symptoms.”
In most studies, participants had treatment with a single inhaler – one inhalation of 80/4.5 milligrams of budesonide/formoterol twice daily, and as needed. Patients in the control groups used their prescribed inhaled corticosteroid with a separate reliever inhaler. Cates and his colleague evaluated three studies that included more than 4,200 adults and adolescents with chronic asthma. One study also included 224 children.
The Cochrane reviewers found no significant reduction in the number of asthma exacerbations that required hospitalization among the patients who used single inhaler therapy.
It was remarked by Cates that one benefit of combined inhalers is that inhaled corticosteroids can be administered on an automatic basis with the beta-agonist when it comes to relieving symptoms.
Posted on November 18th, 2009 by admin | No Comments »
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