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triamcinolone long term effects asthma

Ying Fan, Lian Ma, Jennifer Pippins, Susan Limb, Yun Xu, Chandrahas G Sahajwalla
Inhaled and intranasal corticosteroids (ICS and INS) are among the mainstays of the treatment for asthma and allergic rhinitis, respectively, and also carry the potential to suppress the hypothalamic-pituitary-adrenal (HPA) axis. Several important factors affect the interpretability of trials investigating the impact of ICS and INS on the HPA axis. This paper reviews 106 published clinical trials, peer-reviewed articles, and New Drug Application reviews of approved ICS and INS, using MEDLINE and Drugs@FDA database...
October 2013: Journal of Pharmaceutical Sciences
Benoit Tano, Dev Pathak, Stephen Hoffmann
The National Heart, Lung and Blood Institute guidelines for the treatment of asthma suggest that inhaled corticosteroids, with the addition of a long-acting bronchodilator, may be the most effective long-term control medication for asthma. Five inhaled corticosteroids are approved for use in the USA, including beclomethasone dipropionate, budesonide, flunisolide, triamcinolone acetonide and fluticasone propionate. Fluticasone propionate (Flixotide) and the long-acting beta2 agonist salmeterol (Serevent), are now available in the USA together in an easy to use dry powder inhaler Advair...
December 2003: Expert Review of Pharmacoeconomics & Outcomes Research
Kiriakos Karkoulias, Nikos Charokopos, Alexander Kaparianos, Fotis Sampsonas, Maria Tsiamita, Kostas Spiropoulos
Aseptic (avascular) necrosis of the femoral head in adults has been associated with a variety of disease entities. It is also recognized as a potential complication of systemic corticosteroid therapy. Inhaled corticosteroids are the first line anti-inflammatory agents for the long term treatment of asthma. However, long term treatment of asthma with inhaled corticosteroids has been accompanied by concern about both systemic and topical side effects. The most worrying potential systemic effects are adrenal insufficiency, growth suppression, glaucoma and osteoporosis...
2007: Tüberküloz Ve Toraks
Martha White, Tera Crisalida, Henry Li, Athena Economides, Michael Kaliner
BACKGROUND: Inhaled corticosteroids (ICSs) are effective asthma controllers, but long-term use could lead to adverse effects. OBJECTIVE: To examine adrenal responsiveness of patients with persistent asthma treated with long-term ICSs. METHODS: Morning plasma cortisol levels before and 30 minutes after adrenocorticotropic hormone (ACTH) (1 microg intravenously) stimulation were compared. Primary end points included mean prestimulation and poststimulation cortisol levels; secondary end points included morning cortisol level of 5 microg/dL or less, post-ACTH stimulation cortisol level of 18 microg/dL or less, and/or a net change of 7 microg/dL or less from baseline...
March 2006: Annals of Allergy, Asthma & Immunology
Michelle Zeidler, Jonathan Corren
Current international guidelines for the treatment of asthma advocate inhaled corticosteroids as first-line therapy for persistent symptoms. As chlorofluorocarbon (CFC)-based products are being phased out because of environmental concerns, new inhaler propellants, such as hydrofluoroalkane (HFA)-134a, have been developed. The reformulation of existing corticosteroid compounds into HFA propellants has resulted in two distinct classes of corticosteroid aerosols consisting of HFA suspensions and HFA solutions...
2004: Treatments in Respiratory Medicine
Michael T Halpern, Jordana K Schmier, Maria D Van Kerkhove, Michael Watkins, Chris J Kalberg
BACKGROUND: The impact of long-term inhaled corticosteroid (ICS) therapy on bone mineral density (BMD) is poorly understood. OBJECTIVE: To evaluate the impact of long-term ICS use on BMD. METHODS: Random-effects meta-analysis. Published and unpublished literature were identified by searches of MEDLINE and EMBASE databases and consultation with experts. Studies reporting BMD among adult asthma and chronic obstructive pulmonary disease (COPD) patients using ICS and non-ICS controls were identified...
February 2004: Annals of Allergy, Asthma & Immunology
Florent Richy, Jean Bousquet, George E Ehrlich, Pierre J Meunier, Elliot Israel, Hirotoshi Morii, Jean-Pierre Devogelaer, Nicola Peel, Muriel Haim, Olivier Bruyere, Jean-Yves Reginster
Deleterious effect of oral corticosteroids on bone has been well documented, whereas this remains debated for inhaled ones (ICS). Our objectives were to analyze the effects of ICS on bone mineral density, fracture risk and bone markers. We performed an exhaustive systematic research of all controlled trials potentially containing pertinent data, peer-reviewed by a dedicated WHO expert group, and comprehensive meta-analyses of the data. Inclusion criteria were ICS, and BMD/markers/fractures in asthma/chronic obstructive pulmonary diseases (COPD) and healthy patients...
May 2003: Osteoporosis International
Stuart Stoloff, Kim Poinsett-Holmes, Paul M Dorinsky
Long-acting inhaled beta2-agonists and inhaled corticosteroids are classes of drugs with different mechanisms of action that are commonly used to provide effective long-term control of persistent asthma. Scientific and clinical data support the complementary mechanisms of action of the inhaled corticosteroids and the long-acting beta2-agonists in achieving a superior level of asthma control. In addition, evidence supports significant reductions in exacerbations and effective control of airway inflammation with an inhaled corticosteroid and a long-acting beta2-agonist versus higher dosages of inhaled corticosteroids or combinations of other therapeutic agents with an inhaled corticosteroid...
February 2002: Pharmacotherapy
S Burge
Chronic obstructive pulmonary disease (COPD) is a progressive disease with alveolar destruction (emphysema) and bronchiolar fibrosis (obstructive bronchitis) in variable proportions. Reducing disease progression, as assessed by forced expiratory volume in I second (FEV1) decline, health-related quality of life, exacerbation rate and mortality, is a more realistic outcome than physiological improvement. This paper reviews all the published studies of at least 100 patients followed for at least 2 years. Studies have included patients with mild COPD (Copenhagen City Lung Study) to advanced symptomatic disease [Inhaled Steroids in Obstructive Lung Disease (ISOLDE)], with 2 studies of those with relatively early symptoms [European Respiratory Society Study on Chronic Obstructive Pulmonary Disease (EUROSCOP) and Lung Health-21...
2001: Drugs
E Israel, T R Banerjee, G M Fitzmaurice, T V Kotlov, K LaHive, M S LeBoff
BACKGROUND: Inhaled glucocorticoids are the most commonly used medications for the long-term treatment of patients with asthma. Whether long-term therapy with inhaled glucocorticoids reduces bone mass, as oral glucocorticoid therapy does, is controversial. In a three-year prospective study, we examined the relation between the dose of inhaled glucocorticoids and the rate of bone loss in premenopausal women with asthma. METHODS: We studied 109 premenopausal women, 18 to 45 years of age, who had asthma and no known conditions that cause bone loss and who were treated with inhaled triamcinolone acetonide (100 microg per puff)...
September 27, 2001: New England Journal of Medicine
B J Lipworth, C M Jackson
Although inhaled and intranasal corticosteroids are first-line therapy for asthma and allergic rhinitis, there has recently been an increasing awareness of their propensity to produce systemic adverse effects. The availability of more potent and lipophilic corticosteroids and new chlorofluorocarbon (CFC)-free formulations has focused attention on these safety issues. The main determinant of systemic bioavailability of these drugs is direct absorption from the lung or nose, where there is no first-pass inactivation...
July 2000: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
H S Nelson, R E Kane, J Petillo, D Banerji
In response to environmental concerns regarding chlorofluorocarbon (CFC), two new triamcinolone acetonide (TAA) inhalation aerosol (Azmacort Inhalation Aerosol) formulations have been developed using a more environmentally favorable propellant, HFA-134a (1,1,1,2-tetrafluoroethane). This multicenter, open-label study evaluated the safety of switching asthma patients from TAA-CFC to one of two TAA-HFA formulations. After a 2- or 4-week baseline period during which patients received only CFC-containing TAA Inhaler, 552 patients were randomized to receive TAA-HFA 75 or 225 microg for 6 or 12 months...
April 2000: Journal of Asthma: Official Journal of the Association for the Care of Asthma
L D Jackson, D Polygenis, R A McIvor, I Worthington
Current guidelines emphasize the efficacy of inhaled corticosteroids for anti-inflammatory activity in asthma, and recommend higher doses and earlier initiation of therapy than previous guidelines. Concern over possible side effects with long term use has prompted an evaluation of the available literature to determine the optimal dose that may be administered without fear that significant side effects might occur (e.g., growth retardation in children, adrenal suppression, reduction in bone mineral density, cataract formation)...
1999: Canadian Journal of Clinical Pharmacology, Journal Canadien de Pharmacologie Clinique
B J Lipworth
OBJECTIVE: To appraise the data on systemic adverse effects of inhaled corticosteroids. METHODS: A computerized database search from January 1, 1966, through July 31, 1998, using MEDLINE, EMBASE, and BIDS and using appropriate indexed terms. Reports dealing with the systemic effects of inhaled corticosteroids on adrenal gland, growth, bone, skin, and eye, and reports on pharmacology and pharmacokinetics were reviewed where appropriate. Studies were included that contained evaluable data on systemic effects in healthy volunteers as well as in asthmatic children and adults...
May 10, 1999: Archives of Internal Medicine
P M O'Byrne, S Pedersen
Inhaled corticosteroids are the mainstay of treatment for persistent asthma because of their proven efficacy, which is better than any other class of antiasthma therapy. Concerns about unwanted systemic effects with long-term use has, however, limited their use. Efforts have been made to develop inhaled corticosteroids with less systemic activity for a given clinical effect, thereby improving their therapeutic index. Many different study designs and outcome variables have been used to compare different inhaled corticosteroids...
December 1998: Journal of Allergy and Clinical Immunology
S Veeraraghavan, O P Sharma
Corticosteroids are effective in reducing the airway inflammation and controlling the symptoms of asthma. Many patients with chronic, severe asthma are steroid-dependent, requiring daily oral corticosteroids. Although corticosteroids may be effective, many patients suffer from their intolerable side effects. Various medications have been used as steroid-sparing agents in patients who suffer from the side effects of long-term high-dose steroids. While drugs like methotrexate and cyclosporine are promising, none have clearly been shown to be beneficial in most patients with asthma...
January 1998: Current Opinion in Pulmonary Medicine
B Kos-Kudła, W Pluskiewicz
Female asthma patients (26) with and without corticotherapy were studied. The control group included 19 healthy women. Skeletal status was assessed by ultrasound measurement of the heel (Achilles, Lunar, Madison, WI, USA) and serum and urinary corisol expressed adrenal function. Ultrasound and hormonal values were significantly lower in patients treated with glucocorticosteroids (GC) than in controls. In patients without GC, cortisol parameters were normal and ultrasound measurements were moderately diminished...
1997: Ultrasound in Medicine & Biology
S Chyrek-Borowska, D Obrzut, T Moniuszko, W Szymański
No abstract text is available yet for this article.
August 1981: Pneumonologia Polska
I L Bernstein, P Chervinsky, C J Falliers
Triamcinolone acetonide aerosol (TAA) and a placebo aerosol were compared in a six-week, double-blind multicenter study. Ninety-six steroid-independent asthmatic patients were randomized into two parallel groups. Each patient was evaluated weekly. After four weeks of treatment, those patients treated with TAA showed highly significant (P less than 0.001) improvement from baseline in pulmonary function tests (FEV1, FVC, and FEF25-75%) and in asthmatic symptoms, whereas no significant improvement was observed in those patients who received placebo aerosol...
January 1982: Chest
J R Golub
Eighty percent of 26 steroid-dependent, chronically asthmatic adults eliminated oral steroid dosage after 12 weeks of treatment with triamcinolone acetonide aerosol (800 micrograms/day). After one year of treatment 60% of the patient were free of oral steroids. Pulmonary function (FEV1, FVC and FEF25-75%) and plasma cortisol test results showed significant improvement during treatment. Adverse effects were mild to moderate.
March 1980: Annals of Allergy
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