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Latest & greatest articles for corticosteroids
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Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma Long-term oral corticosteroid (OCS) use in patients with severe asthma is associated with significant adverse effects.This 40-week, randomised, double-blind trial evaluated the OCS-sparing potential of tralokinumab in patients with severe, uncontrolled asthma requiring maintenance OCS treatment plus inhaled corticosteroids/long-acting β2-agonists. Overall, 140 patients were randomised to tralokinumab 300 mg
Corticosteroids as adjunctive therapy in the treatment of influenza. Specific treatments for influenza are limited to neuraminidase inhibitors and adamantanes. Corticosteroids show evidence of benefit in sepsis and related conditions, most likely due to their anti-inflammatory and immunomodulatory properties. Although commonly prescribed for severe influenza, there is uncertainty over their potential benefits or harms. This is an update of a review first published in 2016.To systematically (...) assess the effectiveness and potential adverse effects of corticosteroids as adjunctive therapy in the treatment of influenza, taking into account differences in timing and doses of corticosteroids.We searched CENTRAL (2018, Issue 9), which includes the Cochrane Acute Respiratory infections Group's Specialised Register, MEDLINE (1946 to October week 1, 2018), Embase (1980 to 3 October 2018), CINAHL (1981 to 3 October 2018), LILACS (1982 to 3 October 2018), Web of Science (1985 to 3 October 2018
Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults. Dyspnoea is a common symptom in advanced cancer, with a prevalence of up to 70% among patients at end of life. The cause of dyspnoea is often multifactorial, and may cause considerable psychological distress and suffering. Dyspnoea is often undertreated and good symptom control is less frequently achieved in people with dyspnoea than in people with other symptoms of advanced cancer, such as pain (...) and nausea. The exact mechanism of action of corticosteroids in managing dyspnoea is unclear, yet corticosteroids are commonly used in palliative care for a variety of non-specific indications, including pain, nausea, anorexia, fatigue and low mood, despite being associated with a wide range of adverse effects. In view of their widespread use, it is important to seek evidence of the effects of corticosteroids for the management of cancer-related dyspnoea.To assess the effects of systemic corticosteroids
Comparison Between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial. The aim of the study was to compare the effects of corticosteroid injection with lidocaine injection in treating tennis elbow.It is a prospective, double-blinded, randomized controlled trial. Patients with tennis elbow for more than 1 mo were recruited from a hospital-based rehabilitation outpatient clinic. A total of 70 patients were recruited, and 61 (...) patients completed the study. Patients received an injection of either 10 mg (1 ml) of triamcinolone (corticosteroid group, n = 30) or 1 ml of 1% lidocaine (lidocaine group, n = 31). All of the outcome measures were evaluated before the intervention and at 2 wks and 2 mos after treatment.No significant group differences were observed between the corticosteroid and lidocaine groups regarding Patient-Rated Tennis Elbow Evaluation, Disability of the Arm, Shoulder, and Hand, visual analog scale for pain
Comparison of Infection Risk with Corticosteroid or Hyaluronic Acid Injection Prior to Total Knee Arthroplasty Recent studies have shown that intra-articular injections ≤3 months before total knee arthroplasty increase the risk of periprosthetic joint infection. We are aware of no previous study that has differentiated the risk of periprosthetic joint infection on the basis of the type of medication injected. In addition, we are aware of no prior study that has evaluated whether hyaluronic acid (...) injections increase the risk of infection after total knee arthroplasty. In this study, we utilized pharmaceutical data to compare patients who received preoperative corticosteroid or hyaluronic acid injections and to determine whether a specific injection type increased the risk of periprosthetic joint infection.Patients undergoing unilateral primary total knee arthroplasty were selected from a nationwide private insurer database. Ipsilateral preoperative injections were identified and were grouped
Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis Although corticosteroids are widely used for adults with sepsis, both the overall benefit and potential risks remain unclear.To conduct a systematic review and meta-analysis of the efficacy and safety of corticosteroids in patients with sepsis.MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until March 20, 2018 (...) , and updated on August 10, 2018. The terms corticosteroids, sepsis, septic shock, hydrocortisone, controlled trials, and randomized controlled trial were searched alone or in combination. Randomized clinical trials (RCTs) were included that compared administration of corticosteroids with placebo or standard supportive care in adults with sepsis.Meta-analyses were conducted using a random-effects model to calculate risk ratios (RRs) and mean differences (MDs) with corresponding 95% CIs. Two independent
Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Discover Portal Discover Portal Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Published on 15 January 2019 doi: Taking low-dose theophylline tablets in addition to inhaled corticosteroids did not significantly reduce chronic obstructive pulmonary disease flare-ups (...) recommends the use of this drug only when inhaled bronchodilators are not possible Some small studies have suggested that lower doses of theophylline can increase the anti-inflammatory effect of inhaled corticosteroids and might thereby reduce the risk of exacerbations. This larger scale study helps address this uncertainty. What did this study do? This UK-based trial randomised 1,567 participants to receive either low-dose theophylline or placebo over a year in addition to their corticosteroid inhaler
Moisturisers improve eczema symptoms and lessen the need for corticosteroids Moisturisers improve eczema symptoms and lessen the need for corticosteroids Discover Portal Discover Portal Moisturisers improve eczema symptoms and lessen the need for corticosteroids Published on 27 June 2017 doi: Moisturisers help reduce eczema symptoms compared to no treatment, but to a minor extent. They do lengthen the time between each flare, and reduce the number of flares. Importantly they reduce the amount (...) of corticosteroid creams required. Moisturisers seem well tolerated, though there is little data on patient satisfaction. This Cochrane review of 77 trials does not provide information on which moisturiser might be preferred for different parts of the body or different disease severity. Nevertheless, since moisturisers reduce flares and form part of combined treatment with other active treatments, it makes sense to encourage their continued use. Given the lack of a one size fits all approach, people should have
Corticosteroids improve recovery rates after Bell’s palsy Corticosteroids improve recovery rates after Bell’s palsy Discover Portal Discover Portal Corticosteroids improve recovery rates after Bell’s palsy Published on 29 November 2016 doi: Taking a corticosteroid within 72 hours of Bell’s palsy first appearing reduces the number of people with incomplete facial recovery after six months. Bell’s palsy is a sudden onset of weakness or paralysis of the muscles on one side of the face. Most people (...) recover completely within nine months, often with no treatment, but about three in 10 people are left with some weakness or unwanted facial movements. This Cochrane review found that ten people needed to be treated with corticosteroid, compared to placebo tablets, to avoid one incomplete recovery. It also showed that side effects were uncommon and mild. Corticosteroids are often already prescribed to treat Bell’s palsy in practice. This review confirms that they help. Any further trials should compare
Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Discover Portal Discover Portal Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 doi: Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems in children under five with the rare vascular (...) corticosteroids early to standard treatment within five days of onset of symptoms reduced the risk of serious abnormalities in the heart arteries by more than two thirds. Corticosteroids were not effective when used as rescue treatment after standard treatment had failed. Increasing awareness of the presenting symptoms of children with Kawasaki disease should ensure children are referred early for treatment. Specialist clinicians may want to consider adding corticosteroids to standard treatment
Antenatal corticosteroids reduce breathing problems in late preterm babies Antenatal corticosteroids reduce breathing problems in late preterm babies Discover Portal Discover Portal Antenatal corticosteroids reduce breathing problems in late preterm babies Published on 21 February 2017 doi: Giving corticosteroids to women at risk of preterm birth at 34 weeks of pregnancy or later reduced the risk of severe breathing problems in the baby after birth from 1.9% to 1.1%. Steroids also reduced (...) monitoring. The risks and benefits need to be considered before further recommendations can be made extending the use of antenatal corticosteroids to this late preterm age. This includes exploring the long-term effects and consequences for specific groups of women such as those with diabetes or pregnant with more than one baby. Share your views on the research. Why was this study needed? In the UK, about one baby in every 13 is born prematurely, before 37 weeks of pregnancy. Preterm new-borns
A dose of corticosteroids benefits most women anticipating a preterm delivery A dose of corticosteroids benefits most women anticipating a preterm delivery Discover Portal Discover Portal A dose of corticosteroids benefits most women anticipating a preterm delivery Published on 16 May 2017 doi: Giving corticosteroids to most women who are anticipating labour before completing 37 weeks of pregnancy helps reduce immediate health problems in the baby compared with placebo or no intervention (...) . Deaths around the time of birth were reduced by 28% and babies were a third (34%) less likely to develop respiratory distress syndrome. A corticosteroid dose is already used for women who go into labour or if waters break before 37 weeks or where delivery is planned for other reasons. The drug accelerates the development of the baby’s lungs and reduces breathing difficulties at birth. This recommendation followed decades of research. This review supports current practice of using a dose
Corticosteroid injections provide only short term relief for rotator cuff disorders Corticosteroid injections provide only short term relief for rotator cuff disorders Discover Portal Discover Portal Corticosteroid injections provide only short term relief for rotator cuff disorders Published on 5 October 2016 doi: A corticosteroid steroid injection into the shoulder provides some short-term pain relief for adults with rotator cuff disorders. This review compared injection of corticosteroids (...) for recovery in these painful conditions. Share your views on the research. Why was this study needed? Shoulder disorders are common and affect about three in ten adults at any one time. Rotator cuff disorders are the most common cause of shoulder pain. The tendons in the shoulder can be vulnerable to injury or tear, getting trapped (impingement), or just gradual degeneration of the tendon as a normal part of aging. Giving a corticosteroid injection into the joint is one option to treat pain. Despite
Corticosteroids could help reduce deaths due to blood poisoning Corticosteroids could help reduce deaths due to blood poisoning Discover Portal Discover Portal Corticosteroids could help reduce deaths due to blood poisoning Published on 23 March 2016 doi: Treatment with low dose corticosteroids given over three or more days reduces the death rate from blood poisoning by 13%, saving about 43 lives per 1000 treated at one month. Blood sugar and sodium levels rose slightly (...) but there was no increased risk of gastrointestinal bleeding or additional infection. Current international guidance from 2012 only recommends using corticosteroids as an add-on therapy for people with blood poisoning whose circulation has not been restored by adequate fluid replacement and vasopressors. This review lends some weight to the case for using corticosteroids more widely for sepsis, but is not definitive. This uncertainty is due to inconsistency in results, with some trials finding no difference in mortality
A Randomized Trial of a Long-Acting Depot Corticosteroid Versus Dexamethasone to Prevent Headache Recurrence Among Patients With Acute Migraine Who Are Discharged From an Emergency Department Migraine patients continue to report headache during the days and weeks after emergency department (ED) discharge. Dexamethasone is an evidence-based treatment of acute migraine that decreases the frequency of moderate or severe headache within 72 hours of ED discharge. We hypothesize that intramuscular
Corticosteroid treatment compared to surgery in chronic subdural hematoma: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated
EstablishINg the best STEp-up treatments for children with uncontrolled asthma despite INhaled corticosteroids (EINSTEIN): a systematic review, network meta-analysis and cost effectiveness analysis using individual participant data Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate
Long-term effects of intratracheal administration of corticosteroids to prevent bronchopulmonary dysplasia in preterm infants: a meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content
Intratympanic corticosteroid as salvage therapy in treatment of idiopathic sudden sensorineural hearing loss: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content