The findings appear in the second issue for June 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
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 it is safe for CF patients to stop using inhaled corticosteroids in order to lower their drug burden, to reduce potential adverse side effects, and to save money.
According to the authors, 52 percent of children and 55 percent of the adults with CF in Great Britain have been prescribed inhaled corticosteroid medication for their illness.
CF, an inherited disorder, is characterized by the production of thick, sticky mucus that frequently obstructs the lungs. The problem can lead to life-threatening lung infections and difficulties with the pancreatic ducts, preventing normal digestion and causing patient malnutrition. Because of improved treatment techniques in recent years, however, patient survival has increased from 25 to 33 years.
"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 inhaled corticosteroids (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.
Over a 6-month period, the researchers studied 84 CF patients (median age 14.6 years) who were using an inhaled corticosteroid (fluticasone) and 87 CF patients (median age 15.8 years) who were not.
"Replacing the inhaled corticosteroids with a placebo was found to be safe as there was no significant increase in lung-related adverse effects leading to withdrawal from the study, nor an increased need for oral corticosteroids," said Dr. Balfour-Lynn.
The researchers stressed that they were not advocating stopping inhaled corticosteroid use in all CF patients, but urging clinicians to assess the need in each individual.
"If there is objective evidence that a patients benefited when inhaled corticosteroids were first started, then it is likely they should be continued on the drug," said Dr. Balfour-Lynn.
Suzy Martin | EurekAlert!
Indications of Psychosis Appear in Cortical Folding
26.04.2018 | Universität Basel
GLUT5 fluorescent probe fingerprints cancer cells
20.04.2018 | Michigan Technological University
Magnetic resonance imaging, or MRI, is a widely used medical tool for taking pictures of the insides of our body. One way to make MRI scans easier to read is...
At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.
Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...
Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.
Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
26.04.2018 | Power and Electrical Engineering
26.04.2018 | Life Sciences
26.04.2018 | Power and Electrical Engineering