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Latest & greatest articles for corticosteroids
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Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma 30442714 2019 02 14 1399-3003 53 2 2019 Feb The European respiratory journal Eur. Respir. J. Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma. 1800948 10.1183/13993003.00948-2018 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 β 2 -agonists. Overall, 140 patients were randomised to tralokinumab 300 mg or placebo (n=70 in each group) administered subcutaneously every 2 weeks. The primary end-point was percentage change from baseline in average OCS dose at week 40, while maintaining asthma control. Secondary end-points included proportion of patients with a prescribed maintenance
Corticosteroids as adjunctive therapy in the treatment of influenza. BACKGROUND: 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 (...) . OBJECTIVES: 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. SEARCH METHODS: 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
Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults. BACKGROUND: 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. OBJECTIVES: To assess the effects
Comparison Between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial. 28816704 2019 02 14 2019 02 15 1537-7385 97 2 2018 02 American journal of physical medicine & rehabilitation Am J Phys Med Rehabil Comparison Between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial. 83-89 10.1097/PHM.0000000000000814 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
Comparison of Infection Risk with Corticosteroid or Hyaluronic Acid Injection Prior to Total Knee Arthroplasty 30653040 2019 01 17 1535-1386 101 2 2019 Jan 16 The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Comparison of Infection Risk with Corticosteroid or Hyaluronic Acid Injection Prior to Total Knee Arthroplasty. 112-118 10.2106/JBJS.18.00454 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
Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations Dissemination Centre Discover Portal NIHR DC Discover 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 (...) . NICE guidance 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
Corticosteroid injections provide only short term relief for rotator cuff disorders Signal - Corticosteroid injections provide only short term relief for rotator cuff disorders Dissemination Centre Discover Portal NIHR DC Discover Corticosteroid injections provide only short term relief for rotator cuff disorders Published on 5 October 2016 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 (‘steroids’) with injection of local anaesthetic or placebo. The average improvement in pain relief at two months was calculated as moderate using standardised techniques. The effect wore off by three months. Given the temporary benefits, it may be worth considering other treatments including physiotherapy alongside a steroid injection. Information given by an injecting physiotherapist, for example, regarding the expected duration of pain relief could also help manage
Corticosteroids improve recovery rates after Bell’s palsy Signal - Corticosteroids improve recovery rates after Bell’s palsy Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids improve recovery rates after Bell’s palsy Published on 29 November 2016 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
Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Signal - Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids given early reduce risk of heart problems in children with Kawasaki disease Published on 14 February 2017 Early treatment with corticosteroids on top of standard therapy reduces the risk of serious heart problems in children under five (...) that adding 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
Antenatal corticosteroids reduce breathing problems in late preterm babies Signal - Antenatal corticosteroids reduce breathing problems in late preterm babies Dissemination Centre Discover Portal NIHR DC Discover Antenatal corticosteroids reduce breathing problems in late preterm babies Published on 21 February 2017 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 (...) , which would need 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
Corticosteroids could help reduce deaths due to blood poisoning Signal - Corticosteroids could help reduce deaths due to blood poisoning Dissemination Centre Discover Portal NIHR DC Discover Corticosteroids could help reduce deaths due to blood poisoning Published on 23 March 2016 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
A dose of corticosteroids benefits most women anticipating a preterm delivery Signal - A dose of corticosteroids benefits most women anticipating a preterm delivery Dissemination Centre Discover Portal NIHR DC Discover A dose of corticosteroids benefits most women anticipating a preterm delivery Published on 16 May 2017 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
Moisturisers improve eczema symptoms and lessen the need for corticosteroids Signal - Moisturisers improve eczema symptoms and lessen the need for corticosteroids Dissemination Centre Discover Portal NIHR DC Discover Moisturisers improve eczema symptoms and lessen the need for corticosteroids Published on 27 June 2017 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
Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature 30190274 2018 10 26 1399-3003 52 4 2018 Oct The European respiratory journal Eur. Respir. J. Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature. 1800703 10.1183/13993003.00703-2018 This review provides an overview of the role of long (...) -term treatment of severe asthma with oral corticosteroids (OCS) and its associated side-effects in adults. It is based on a systematic literature search conducted in MEDLINE, Embase and the Cochrane Library to identify relevant studies. After a short overview of severe asthma and its treatment we present studies showing a dose-response relationship in asthmatic patients treated with OCS and then consider by organ systems the undesired effects demonstrated in clinical and epidemiological studies
Corticosteroids for septic arthritis in children. BACKGROUND: Septic arthritis is an acute infection of the joints characterised by erosive disruption of the articular space. It is the most common non-degenerative articular disease in developing countries. The most vulnerable population for septic arthritis includes infants and preschoolers, especially boys. Septic arthritis disproportionately affects populations of low socioeconomic status. Systemic corticosteroids and antibiotic therapy may (...) be beneficial for treatment of septic arthritis. Even if the joint infection is eradicated by antibiotic treatment, the inflammatory process may produce residual joint damage and sequelae. OBJECTIVES: To determine the benefits and harms of corticosteroids as adjunctive therapy in children with a diagnosis of septic arthritis. SEARCH METHODS: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, Latin American Caribbean Health Sciences Literature
Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Signal - Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Dissemination Centre Discover Portal NIHR DC Discover Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis Published on 22 December 2015 The authors of this systematic review found that high-volume saline irrigation and corticosteroid (...) nasal sprays were effective at reducing symptoms of sinusitis. They recommend a combination of these two therapies as the first line treatment of choice, in accordance with guidelines from the Royal College of Surgeons and ENT UK. In addition they found that, in those with nasal polyps, corticosteroids sprays reduced the polyp size, and during acute exacerbations a two to three week course of oral corticosteroids, doxycycline or a leukotriene antagonist was the most effective strategy. For those
Corticosteroids Provide Better Postoperative Endodontic Pain Relief Compared to Placebo (CAT#3350) UTCAT3350, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Corticosteroids Provide Better Postoperative Endodontic Pain Relief Compared to Placebo Clinical Question In patients receiving non-surgical endodontic therapy, do corticosteroids provide better postoperative endodontic pain relief compared to placebo? Clinical (...) Bottom Line Corticosteroids provide better postoperative endodontic pain relief compared to placebo. Different types and dosages of corticosteroids have different levels of analgesic efficacy. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Shamszadeh/2018 1088 patients in 18 Randomized clinical trials Systematic Review and Meta-Analysis Key results Patients who received corticosteroids had greater