Posts Tagged ‘inhaled steroids’

There may be some children may not experience the same benefits of inhaled corticosteroids for keeping their asthma under control, as per a study.

“There may be several reasons for our findings; It is possible that some children are genetically less responsive to steroids,” says researcher Gregory Sawicki, M.D. of Children’s Hospital in Boston.

From Sciencedaily.com:

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.”

“In addition to issues of medication adherence and inability to completely control for differences in underlying asthma, severity can never be completely ruled out,” Sawicki said.

A potential drug has been identified for providing relief to individuals suffering with hay fever and asthma and will soon underwent trials in humans.

RPL554, the drug, possess the ability of treating respiratory diseases and its use does not lead to side effects that are common with present-day 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.

Dr. Clive Page, chairman of Verona Pharma, which is presently developing the treatment, said the company is examining other novel compounds for tackling respiratory ailments on the lines of anti-inflammatory substances that are found in starfish and a treatment for coughs.

Children suffering from asthma but making it a point to get themselves engage into physical fitness can exercise a better control on the disease besides improving the quality of life, as per a study published recently in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine (ACSM).

The study results suggested aerobic training as effective to improve cardiopulmonary fitness and reduce 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, remarked that physical training could be a management strategy for symptoms of asthma in children.

A recently concluded study of senior citizens at John Hopkins found that most of the elderly people have either moderate or severe asthma, which is either under-diagnosed or unattended.

Karen Huss, DNSc, RN, a nurse researcher and associate professor at The Johns Hopkins University School of Nursing, remarked that asthma can lead to 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.

Individuals suffering from the mild form of asthma can effectively manage their ailment with a twice-daily use of inhaled steroids or switching to a daily pill, as per a new research.

These results were reported in the May 17 issue of the New England Journal of Medicine.

Stephen P. Peters, M.D., Ph.D., lead author and a professor of pediatrics, internal medicine-pulmonary and associate director of the Center for Human Genomics, said that this is great news for asthmatic patients with a mild and persistent form of the disease as it provides them more options for asthma management.

From News-Medical.Net:

Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month. The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms. Patients may also take additional drugs such as the inhaler albuterol, known as “rescue” therapy, to treat symptoms. A majority of people with asthma have mild disease, according to Peters.

The study involved patients whose asthma was treated with twice-daily inhaled fluticasone propionate (Flovent Discus), a commonly prescribed synthetic steroid. This drug is designed to suppress inflammation within the airways that can cause narrowing.

Peters further said that patients administered with twice-daily fluticasone and managing their ailment effectively may be switched to once-daily flucitasone/salmeterol without higher rates of treatment failure.

A new drug for curing asthma patients, RPL554, which faced trials at the Centre for Human Drug Research (CHDR) in the Netherlands on more than 60 people in 2008, is now moving to the stage of further trials during 2009.

This drug, which is considered by many as nothing but a wonder drug, is likely to prove its worth in treating more than 1.5 million people in the United States alone suffering from asthma and hay fever. It is expected that drug will reach the market in the next three to four years after evaluating its safety and efficacy.

From News-Medical.Net:

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 some researchers that this once-a-day asthma treatment option will be nothing less than a first-line therapy for treating patients suffering from hay fever and asthma. The discovery of this drug would mean that asthmatic patients will now require only a single needle puff from their “lifesaving” inhalers to stop the symptoms.

Dr. E. R. Sutherland, from the University of Colorado Health Sciences Center in Denver, and colleagues, conducted an analysis of the data results in eight studies in order to determine if steroids improve the breathing of patients with COPD. Each trial were participated by almost 4,000 patients and lasted for two years.

Results showed that inhaled steroids could slow down the effects of COPD in patients, which is restricted inhalation and exhalation. COPD patients usually experience a decrease in their ability to take in large volumes of air and their ability to exhale air is restricted.

COPD patients were established to benefit greatly from inhaled steroids especially if administered in large doses.

COPD encompasses different respiratory diseases such as emphysema and bronchitis. These two most common COPD condition is closely linked to cigarette smoking. It is reported to be the fourth leading cause of death in the United States.

Researchers concluded that a large dose of steroids is effective in slowing down the effects of COPD. However, further studies should be conducted to identify the ideal dose and the best time for administration, as well as other drugs that work best with steroids.

From Online News Pakistan:

ISLAMABAD : While inhaled steroids undoubtedly help patients with asthma, doctors have seesawed on whether these drugs are useful for a common lung problem called chronic obstructive pulmonary disease (COPD).

A combination of airway-opening drugs and inhaled steroids with inflammation-reducing characteristics works better for preventing severe asthma attacks than a normal dose of steroids alone, according to a new review of recent studies.

It was proved during the study that higher doses of steroids are as effective as the combination therapy in itself for preventing asthma attacks, according to a second review.

From News-Medical.Net:

Asthma patients who used both LABA medication and an inhaled steroid were significantly less likely to have a severe asthma flare-up requiring treatment with an injected or swallowed steroid than patients taking the steroid alone, according to Muireann Ni Chroinin, M.D., of the Norfolk and Norwich University Hospital in England, and colleagues.

The reviews appear 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 rate of severe attacks dropped from 27 percent to 22 percent in patients taking the combination therapy. Ni Chroinin and colleagues calculate that 18 patients would need to be treated with LABA for one year to prevent at least one patient from having such an attack.

Jerry Krishnan, M.D., an asthma researcher and assistant professor of medicine and epidemiology at the Johns Hopkins University School of Medicine, remarked that he believes that there is a propensity for initiating combination therapy with LABAs (long acting beta-2 agonists) and inhaled corticosteroids.