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Long term effects corticosteroids ad

Matteo Megna, Maddalena Napolitano, Cataldo Patruno, Alessia Villani, Anna Balato, Giuseppe Monfrecola, Fabio Ayala, Nicola Balato
Atopic dermatitis (AD) is a common chronic inflammatory skin disease that predominantly affects children. However, it can persist in adulthood and/or start at older ages. Due to its chronic nature and frequently occurring relapses, AD has a substantial effect on patients' quality of life, often requiring long-term systemic treatment, especially in adult patients, who are more frequently refractory to adequate topical treatment with mid- to high-potent corticosteroids and/or calcineurin inhibitors. Therefore, treatment with systemic therapies is often needed to take control of the disease, prevent exacerbations and improve quality of life...
December 26, 2016: Dermatology and Therapy
Melanie D Whittington, R Brett McQueen, Daniel A Ollendorf, Jeffrey A Tice, Richard H Chapman, Steven D Pearson, Jonathan D Campbell
BACKGROUND: Adding mepolizumab to standard treatment with inhaled corticosteroids and controller medications could decrease asthma exacerbations and use of long-term oral steroids in patients with severe disease and increased eosinophils; however, mepolizumab is costly and its cost effectiveness is unknown. OBJECTIVE: To estimate the cost effectiveness of mepolizumab. METHODS: A Markov model was used to determine the incremental cost per quality-adjusted life year (QALY) gained for mepolizumab plus standard of care (SoC) and for SoC alone...
December 3, 2016: Annals of Allergy, Asthma & Immunology
E Cantone, M Iengo
BACKGROUND: Available medical treatments for chronic rhinosinusitis (CRS) with nasal polyposis (CRSwNP) comprise systemic and topical therapies. Although topical corticosteroids are effective in the treatment of CRS, they are not completely devoid of adverse effects. Thus, care has to be taken when long-term treatments are prescribed. There is recent evidence that sodium hyaluronate (SH), the major component of many extracellular matrices, promotes tissue healing, including activation and moderation of the inflammatory responses, cell proliferation, migration, and angiogenesis...
June 2, 2016: American Journal of Rhinology & Allergy
Polychronis Pavlidis, Panagiotis Stamoulos, Answar Abdulrehman, Patrick Kerr, Claire Bull, John Duley, Azhar Ansari
BACKGROUND: Low-dose azathioprine with allopurinol (LDAA) has been proposed as a potent therapy in inflammatory bowel disease (IBD) with the benefit of overcoming side effects regularly associated with thiopurine monotherapy and poor responses. Concerns regarding safety remain, while a layer of complexity has been added by the trend toward treatment directed by red cell thioguanine nucleotide (TGN) profiling. We report on the clinical efficacy and safety of LDAA use in IBD undirected by metabolite profiling...
July 2016: Inflammatory Bowel Diseases
Elaine C Siegfried, Jennifer C Jaworski, Jennifer D Kaiser, Adelaide A Hebert
BACKGROUND: Many clinicians have concerns about the safety of atopic dermatitis (AD) treatments, particularly in children requiring long-term daily maintenance therapy. Topical corticosteroids (TCS) have been widely used for >5 decades. Long-term TCS monotherapy has been associated with adverse cutaneous effects including atrophy, rebound flares, and increased percutaneous absorption with potential for adverse systemic effects. Topical calcineurin inhibitors (TCIs), tacrolimus and pimecrolimus, available for 1-2 decades, are not associated with atrophy or increased percutaneous absorption after prolonged use and have much lower potential for systemic effects...
June 7, 2016: BMC Pediatrics
Jonathan I Silverberg, Diane B Nelson, Gil Yosipovitch
Atopic dermatitis (AD), a chronic inflammatory skin disease affecting children and adults, presents as mild-to-moderate disease in the majority of patients. Pruritus, one of the key diagnostic criteria for AD, is associated with reduced quality of life and disease aggravation. Current treatments include emollients and topical pharmaceutical agents. Topical corticosteroids (TCSs) are commonly used, but are associated with safety concerns with cutaneous and systemic side effects. Topical calcineurin inhibitors (TCIs) inhibit T-lymphocyte activation, but their use is limited because of application-site infections and a boxed warning for potential malignancy risk...
November 2016: Journal of Dermatological Treatment
Steven Piper, Heather M Shearer, Pierre Côté, Jessica J Wong, Hainan Yu, Sharanya Varatharajan, Danielle Southerst, Kristi A Randhawa, Deborah A Sutton, Maja Stupar, Margareta C Nordin, Silvano A Mior, Gabrielle M van der Velde, Anne L Taylor-Vaisey
BACKGROUND: Soft-tissue therapy is commonly used to manage musculoskeletal injuries. OBJECTIVE: To determine the effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities. DESIGN: Systematic Review. METHODS: We searched six databases from 1990 to 2015 and critically appraised eligible articles using Scottish Intercollegiate Guidelines Network (SIGN) criteria...
February 2016: Manual Therapy
Ildiko Gagyor, Vishnu B Madhok, Fergus Daly, Dhruvashree Somasundara, Michael Sullivan, Fiona Gammie, Frank Sullivan
No abstract text is available yet for this article.
September 7, 2015: Cochrane Database of Systematic Reviews
Keith T Beam, Christopher A Coop
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) is a common serious hypersensitivity reaction to airway colonization with Aspergillus in patients with asthma or cystic fibrosis. While steroids are effective in controlling the respiratory symptoms of ABPA, they have many side effects that make them undesirable for long term use. Antifungals have been used to reduce dependency on systemic steroids but long term use can be limited by side effects and there is the possibility of developing resistance to azoles...
January 2015: Allergy & Rhinology
Debbie E Anderson, Kayleigh M Kew, Anne C Boyter
BACKGROUND: Despite the availability of several evidence-based therapies and non-pharmacological strategies to improve control of symptoms and prevent exacerbations of asthma, patients with asthma continue to be at risk for mortality and morbidity.Previous trials have demonstrated the potentially beneficial effects of the long-acting muscarinic antagonist (LAMA) tiotropium on lung function in patients with asthma; however, a definitive conclusion on the benefit of LAMA in asthma is lacking, as is information on where in the current step-wise management strategy they would be most beneficial...
2015: Cochrane Database of Systematic Reviews
Ildiko Gagyor, Vishnu B Madhok, Fergus Daly, Dhruvashree Somasundara, Michael Sullivan, Fiona Gammie, Frank Sullivan
BACKGROUND: Corticosteroids are widely used in the treatment of idiopathic facial paralysis (Bell's palsy), but the effectiveness of additional treatment with an antiviral agent is uncertain. Significant morbidity can be associated with severe cases of Bell's palsy. OBJECTIVES: To assess the effects of antiviral treatments alone or in combination with any other therapy for Bell's palsy. SEARCH METHODS: On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA...
July 1, 2015: Cochrane Database of Systematic Reviews
Kayleigh M Kew, David J W Evans, Debbie E Allison, Anne C Boyter
BACKGROUND: Poorly controlled asthma and preventable exacerbations place a significant strain on healthcare, often requiring additional medications, hospital stays or treatment in the emergency department.Long-acting beta2-agonists (LABA) are the preferred add-on treatment for adults with asthma whose symptoms are not well controlled on inhaled corticosteroids (ICS), but have important safety concerns in asthma. Long-acting muscarinic antagonists (LAMA) have confirmed efficacy in chronic obstructive pulmonary disease and are now being considered as an alternative add-on therapy for people with uncontrolled asthma...
2015: Cochrane Database of Systematic Reviews
U Tozzi, V Santillo, G P Tartaro, A Sellitto, G R Gravino, M Santagata
INTRODUCTION: Orthognathic surgery involves making several osteotomies. Any osteotomies leads to varying degrees of post-operative swelling. The aim of this study was to evaluate the effectiveness of anti-edema drugs for the control of edema, using Digitizer 3D™ for measuring soft-tissue thickness, in patients who underwent bimaxillaryorthognathic surgery. MATERIALS AND METHODS: In this double-blinded, randomized, control trial, 24 patients (study group: 12 patients, control group: 12 patients) in whom bimaxillary orthognathic surgery was indicated, were included in this study...
June 2015: Journal of Maxillofacial and Oral Surgery
Ildiko Gagyor, Vishnu B Madhok, Fergus Daly, Dhruvashree Somasundara, Michael Sullivan, Fiona Gammie, Frank Sullivan
BACKGROUND: Corticosteroids are widely used in the treatment of idiopathic facial paralysis (Bell's palsy), but the effectiveness of additional treatment with an antiviral agent is uncertain. Significant morbidity can be associated with severe cases of Bell's palsy. OBJECTIVES: To assess the effects of antiviral treatments alone or in combination with any other therapy for Bell's palsy. SEARCH METHODS: On 7 October 2014 we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, DARE, NHS EED, and HTA...
2015: Cochrane Database of Systematic Reviews
Nathaniel A Slater, Dean S Morrell
Atopic dermatitis (AD) is a common childhood inflammatory disease that, in a small percentage of cases, can become severe enough to require potent systemic treatment. Many trials have been conducted with systemic agents for the treatment of severe pediatric AD; we review the evidence here. Although corticosteroids are widely used in practice, they are not generally recommended as a systemic treatment option for AD in children. Most patients experience a relatively rapid and robust response to cyclosporine. Treating children with cyclosporine long term is troubling; however, azathioprine, mycophenolate mofetil, and methotrexate are all reasonable alternatives for maintenance therapy in recalcitrant cases...
May 2015: Clinics in Dermatology
Bardur Sigurgeirsson, Andrzej Boznanski, Gail Todd, André Vertruyen, Marie-Louise A Schuttelaar, Xuejun Zhu, Uwe Schauer, Paul Qaqundah, Yves Poulin, Sigurdur Kristjansson, Andrea von Berg, Antonio Nieto, Mark Boguniewicz, Amy S Paller, Rada Dakovic, Johannes Ring, Thomas Luger
BACKGROUND AND OBJECTIVES: Atopic dermatitis (AD) primarily affects infants and young children. Although topical corticosteroids (TCSs) are often prescribed, noncorticosteroid treatments are needed because compliance with TCSs is poor due to concerns about their side effects. In this longest and largest intervention study ever conducted in infants with mild-to-moderate AD, pimecrolimus 1% cream (PIM) was compared with TCSs. METHODS: A total of 2418 infants were enrolled in this 5-year open-label study...
April 2015: Pediatrics
Li Liu, Jian Hu, Jijun Ma, Xiaojie Li, Fangfang Li, Chongwei Li
OBJECTIVE: To summarize the clinical characteristics, diagnosis and treatment of a case with autoimmune lymphoproliferative syndrome (ALPS) . METHOD: The patient was diagnosed as autoimmune lymphoproliferactive syndrome (ALPS) after being admitted to the Department of Rheumatism and Immunology of Tianjin Children's Hospital in February 20, 2014. The clinical characteristics, physical examination, laboratory tests, gene tests, and treatment process were analyzed and related literature was reviewed...
December 2014: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Mohsen Sadatsafavi, Larry D Lynd, Mary A De Vera, Zafar Zafari, J Mark FitzGerald
BACKGROUND: Much of the evidence on the early use of inhaled controllers after severe asthma exacerbations is about their short-term benefit, leaving a gap in evidence on their longer-term outcomes. METHODS: We used administrative health data from British Columbia, Canada (2001-2012) to evaluate readmission rate (primary outcome), adherence to controller medications, and use of reliever medications associated with different inhaled controller treatments as an add-on to systemic corticosteroids (SCS) over one-year following discharge from an asthma-related admission in individuals 12-55 years of age...
March 2015: Respiratory Medicine
Donatella Talini, Federica Novelli, Elena Bacci, Marialaura Bartoli, Silvana Cianchetti, Francesco Costa, Federico L Dente, Antonella Di Franco, Manuela Latorre, Laura Malagrinò, Barbara Vagaggini, Alessandro Celi, Pierluigi Paggiaro
OBJECTIVE: To evaluate the potential determinants of forced expiratory volume in 1 s (FEV1) decline in workers with occupational asthma (OA) still exposed to the causative agent. We hypothesised that sputum eosinophilia might be a predictor of poor asthma outcome after diagnosis. SETTING, DESIGN AND PARTICIPANTS: In a specialistic clinical centre of the University Hospital of Pisa, we studied 39 participants (28 M, 11 F) diagnosed as having OA, routinely followed up between 1990 and 2009...
2015: BMJ Open
Thomas Luger, Mark Boguniewicz, Warner Carr, Michael Cork, Mette Deleuran, Lawrence Eichenfield, Philippe Eigenmann, Regina Fölster-Holst, Carlo Gelmetti, Harald Gollnick, Eckard Hamelmann, Adelaide A Hebert, Antonella Muraro, Arnold P Oranje, Amy S Paller, Carle Paul, Luis Puig, Johannes Ring, Elaine Siegfried, Jonathan M Spergel, Georg Stingl, Alain Taieb, Antonio Torrelo, Thomas Werfel, Ulrich Wahn
Atopic dermatitis (AD) is a distressing dermatological disease, which is highly prevalent during infancy, can persist into later life and requires long-term management with anti-inflammatory compounds. The introduction of the topical calcineurin inhibitors (TCIs), tacrolimus and pimecrolimus, more than 10 yr ago was a major breakthrough for the topical anti-inflammatory treatment of AD. Pimecrolimus 1% is approved for second-line use in children (≥2 yr old) and adults with mild-to-moderate AD. The age restriction was emphasized in a boxed warning added by the FDA in January 2006, which also highlights the lack of long-term safety data and the theoretical risk of skin malignancy and lymphoma...
June 2015: Pediatric Allergy and Immunology
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