Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety

Short courses of systemic corticosteroids (SCS), both oral and injectable, are very effective for the resolution of acute asthma symptoms, including exacerbations. However, the benefits of SCS, even short courses, must be balanced against the impact of their side-effects. While the adverse consequences of long-term use are widely recognised, there appears to be a perception in the medical community that short courses of SCS are safe. Limited but growing evidence in the literature suggests that even very brief dosing periods (3–7 days) of SCS are enough to cause significantly negative outcomes for patients. Short courses of SCS are associated with increased risk of adverse events including loss of bone density, hypertension and gastrointestinal ulcers/bleeds, in addition to serious impacts on mental health. Strategies to improve asthma control are recommended, including: 1) as-needed combination therapies in mild asthma; 2) risk factor reduction; 3) improving adherence/inhaler technique; 4) earlier initiation of add-on therapies; 5) use of biologics in appropriate patients; 6) development of new therapies to better control the disease; and 7) widespread education of the medical community. We propose that patients and primary care physicians should consider a cumulative SCS dose of 1 g per year as a highly relevant and easy-to-recall threshold.
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Reviews Source Type: research

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CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making. PMID: 32141261 [PubMed]
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion The choice of CMA estimates and sliding window parameters has a major impact on the performance of a clustering algorithm to identify distinct longitudinal adherence trajectories. We recommend (a) assuming constant adherence between refills, (b) avoiding dichotomization based on a threshold, and (c) exploring optimal sliding windows parameters in simulation studies or selecting shorter non-overlapping windows for the accurate and robust identification of different adherence patterns from electronic healthcare data. Author Contributions SA and DD programmed the simulations. SA performed the analyses and wrote ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion This paper summarizes the current findings regarding the anti-colitis activity of plant-derived alkaloids and shows how these alkaloids exhibit significant and beneficial effects in alleviating colonic inflammation. These natural alkaloids are not only promising agents for IBD treatment but are also components for developing new wonder drugs. However, the underlying molecular mechanisms or toxicological evaluation of most plant-derived alkaloids still require much scientific research, and their actual efficacies for IBD patients have not been verified well in field research. Thus, further clinical trials to elu...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
;alık İ, Merzifonlu O Abstract Introduction: Understanding the difference of elderly asthma is essential to provide better healthcare for this vulnerable population. The aim of this study was to evaluate the differences between young and elderly asthma patients. Materials and Methods: This real-life study was designed as a cross-sectional analysis. All data collected with structured web based asthma program. In sum, 373 (89.9%) young asthma (YA, age
Source: Tuberkuloz ve Toraks - Category: Respiratory Medicine Authors: Tags: Tuberk Toraks Source Type: research
AbstractIntroductionRecurrent hypoxia makes asthmatics at risk for pulmonary hypertension and ventricular dysfunction. Early stages of these cardiovascular diseases cannot be detected by conventional echocardiography. Tissue Doppler imaging has been introduced recently as a more sensitive&more accurate tool for investigating cardiovascular diseases.Objectiveinvestigating ventricular functions in asymptomatic asthmatic children using tissue Doppler echocardiography.Method50 asthmatic children and 50 controls were examined by conventional echocrdiography. Tissue Doppler echocardiography was performed to measure the myoca...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Publication date: November–December 2018Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 6Author(s): Luke E. Barry, Ciaran O'Neill, Chris Patterson, Joan Sweeney, David Price, Liam G. HeaneyBackgroundTreatment of severe asthma may include high-dose systemic corticosteroid therapy, which is associated with substantial comorbidity. There is evidence to suggest that this burden is not evenly distributed across age, sex, and corticosteroid exposure levels.ObjectiveTo examine the associations between age, sex, comorbidity, and patterns of health care cost across groups differentiated by...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusions The results of this study provide evidence suggesting the safety of LABAs for the treatment of asthma in pregnancy, in terms of the risks of HDP and preeclampsia/eclampsia.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Seasonal allergies can be frustrating. When spring crawls in, many people begin to experience all-too-familiar itchy and watery eyes, runny nose, and congestion. Symptoms of seasonal allergies are the result of an immune system in overdrive in response to pollen and other allergens. Those bothersome symptoms are intended to protect you from unwanted foreign particles, but in this situation they end up causing misery. There are quite a few options when it comes to controlling allergy symptoms, but we want to watch out for a few that can be quite dangerous when used incorrectly. Nasal steroids The first-line treatment for se...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Asthma and Allergies Ear, nose, and throat Health Source Type: blogs
The woman next to me in the checkout line looked upset. Her eyes were red and her nose was running. My first thought was to give her privacy, until I saw her shopping basket filled with supplies to fight allergy symptoms, and then our eyes met. “I can’t believe how bad my allergies are this year!” she said, exasperated. My fellow shopper isn’t the only one suffering. “Warm weather and a mild winter, as we’ve experienced this year, can stimulate trees to pollinate. The southern U.S., which has a warmer climate, is particularly susceptible to earlier allergy seasons. Other climate factors ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Asthma and Allergies Source Type: blogs
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