High Dose Budesonide Has a Steroid-Sparing Effect

InPharma ◽  
1986 ◽  
Vol 555 (1) ◽  
pp. 11-11
Keyword(s):  
High Dose ◽  
Sparing Effect ◽  
Steroid Sparing

Tiotropium for Adults with Inadequately Controlled Persistent Asthma

2013 ◽  
Vol 47 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Katie S Adams ◽  
Denise K Lowe
Keyword(s):  
Clinical Trials ◽  
Pulmonary Function ◽  
Case Reports ◽  
Pulmonary Function Tests ◽  
Persistent Asthma ◽  
High Dose ◽  
Function Tests ◽  
Sparing Effect ◽  
Steroid Sparing

OBJECTIVE To review the literature evaluating the efficacy and steroid-sparing effect of tiotropium for inadequately controlled persistent asthma in adults. DATA SOURCES Information was obtained through a search of MEDLINE/PubMed (1966-October 2012), using the terms asthma and tiotropium. A further review of reference citations was performed to identify other relevant articles. STUDY SELECTION AND DATA EXTRACTION English-language case reports and clinical trials were reviewed. Publications evaluating the efficacy and steroid-sparing effect of tiotropium in adults with inadequately controlled persistent asthma were included in the review. One case report and 5 clinical trials met our criteria. DATA SYNTHESIS The ultimate goal for asthma management is to maintain disease control by preventing acute exacerbations while avoiding adverse medication effects. Inhaled corticosteroids (ICS) are part of all preferred maintenance regimens for persistent asthma. Unfortunately, persistent asthma remains inadequately controlled in some patients and concerns about serious adverse effects with long-term high-dose ICS treatment exist. Interest in the use of tiotropium to control asthma symptoms and reduce steroid requirements in inadequately controlled persistent asthma is emerging. Results of several trials indicate that tiotropium improves pulmonary function markers and reduces corticosteroid requirements. Moreover, the largest and longest published trial not only showed improvements in pulmonary function tests but also a reduction in corticosteroid use and an increase in the time to first exacerbation. CONCLUSIONS Although tiotropium use in treatment of persistent asthma appears to be promising, more robust clinical trials are needed to assess whether improved pulmonary function tests as well as a decrease in asthma exacerbations and corticosteroid requirements translate into improvements in quality of life. Additionally, the optimal patient population, long-term efficacy, and safety of tiotropium when delivered by various methods need to be determined before it can be recommended over current alternative asthma therapies.

Steroid-sparing effect of inhaled lysine acetylsalicylate and furosemide in high-dose beclomethasone–dependent asthma

1995 ◽  
Vol 95 (5) ◽  
pp. 937-943 ◽  
Author(s):  
S BIANCO ◽  
A VAGHI ◽  
M ROBUSCHI ◽  
R REFINI ◽  
M PIERONI ◽  
...  
Keyword(s):  
High Dose ◽  
Lysine Acetylsalicylate ◽  
Sparing Effect ◽  
Steroid Sparing

scholarly journals POS0338 STEROID-SPARING EFFECT OF ANAKINRA IN GIANT-CELL ARTERITIS: A CASE SERIES WITH CLINICAL, BIOLOGICAL AND ICONOGRAPHIC LONG-TERM ASSESSMENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 397.1-397
Author(s):  
S. Deshayes ◽  
K. Ly ◽  
V. Rieu ◽  
G. Maigné ◽  
N. M. Silva ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Interleukin 1 ◽  
Oral Prednisone ◽  
Large Vessel ◽  
Daily Dose ◽  
Sparing Effect ◽  
Steroid Sparing

Background:The treatment of giant cell arteritis (GCA) relies on corticosteroids but is burdened by a high rate of relapses and adverse effects. Anti-interleukin-6 treatments show a clear benefit with a significant steroid-sparing effect, but late relapses occur after treatment discontinuation. In addition to interleukin-6, interleukin-1 also appears to play a significant role in GCA pathophysiology.Objectives:We report herein the efficacy of anakinra, an interleukin-1 receptor antagonist, in 6 GCA patients exhibiting corticosteroid dependence or resistance, specifically analyzing the outcome of aortitis in 4 of them, and including the long-term follow-up of 2 previously described patients (1).Methods:This retrospective study analyzed the cases of all GCA patients treated with anakinra from the French Study Group for Large Vessel Vasculitis.Patients had to satisfy the following two criteria to be enrolled in this retrospective study. First, their diagnosis of GCA should be based on the fulfillment of at least 3 criteria of the American College of Rheumatology (ACR) for GCA or on the satisfaction of 2 of these criteria along with the demonstration of LVI on imaging. Second, patients should have received anakinra because of corticosteroid dependence or resistance.Corticosteroid dependence was defined as ≥2 relapses or the combination of 2 of the following criteria: a daily dose of oral prednisone >20 mg/day (or 0.3 mg/kg) at 6 months; a daily dose of oral prednisone >10 mg/day (or 0.2 mg/kg) at 12 months; and/or a treatment maintained >24 months because of a relapsing disease course. Corticosteroid resistance was defined as persistent increased inflammatory parameters at month 3 despite a steroid dosage over 0.5 mg/kg.Results:After a median duration of anakinra therapy of 19 [18–32] months, all 6 patients exhibited complete clinical and biological remission. Among the 4 patients with large-vessel involvement, 2 had a disappearance of aortitis under anakinra, and 2 showed a decrease in vascular uptake. After a median follow-up of 56 [48–63] months, corticosteroids were discontinued in 4 patients, and corticosteroid dosage could be decreased to 5 mg/day in 2 patients. One patient relapsed 13 months after anakinra introduction in the context of increasing the daily anakinra injection interval to every 48 hours. Three patients experienced transient injection-site reactions, and 1 patient had pneumonia.Figure 1.Steroid dosages before and after the introduction of anakinra in 6 patients with giant-cell arteritis and corticosteroid dependence or resistance. The black arrow indicates the time of anakinra introduction.Conclusion:In this short series, anakinra appears to be an efficient and safe steroid-sparing agent in refractory GCA, with a possible beneficial effect on large-vessel involvement.References:[1]Ly K-H, Stirnemann J, Liozon E, Michel M, Fain O, Fauchais A-L. Interleukin-1 blockade in refractory giant cell arteritis. Joint Bone Spine 2014;81:76–8.Disclosure of Interests:Samuel Deshayes: None declared, Kim LY: None declared, Virginie Rieu: None declared, Gwénola Maigné: None declared, Nicolas Martin Silva: None declared, Alain Manrique: None declared, Jacques Monteil: None declared, Hubert de Boysson Speakers bureau: Roche-Chugai, Grant/research support from: Roche-Chugai, Achille Aouba Grant/research support from: SOBI

Omalizumab in chronic spontaneous urticaria: steroid sparing effect

2018 ◽  
Vol 29 (sup3) ◽  
pp. 6-9 ◽  
Author(s):  
Alessia Gatta ◽  
Loredana Della Valle ◽  
Anila Farinelli ◽  
Enrico Cavallucci ◽  
Roberto Paganelli ◽  
...  
Keyword(s):  
Chronic Spontaneous Urticaria ◽  
Sparing Effect ◽  
Steroid Sparing

Impact of rituximab on anthropometric indices among childhood steroid-dependent nephrotic syndromes

2020 ◽  
pp. archdischild-2019-318019
Author(s):  
Rajiv Sinha ◽  
Sushmita Banerjee ◽  
Anwesha Mukherjee ◽  
Shakil Akhtar ◽  
Subal Pradhan
Keyword(s):  
Body Mass Index ◽  
Short Stature ◽  
Body Mass ◽  
Retrospective Review ◽  
Anthropometric Parameters ◽  
Anthropometric Indices ◽  
Steroid Dependent ◽  
Sparing Effect ◽  
Steroid Sparing

BackgroundThere is scarcity of data on impact of rituximab on anthropometrical parameters (weight, height and body mass index i.e. BMI SD score (SDS)) among children with steroid-dependent nephrotic syndromes (SDNS).MethodsMulticentre retrospective review.Results102 children with SDNS (male: 63%; n=64), median age 7 (IQR: 4.3–9.6) years, received a total of 217 rituximab infusions (total 110 cycles). At median follow-up of 2.1 (IQR: 1.3–2.8) years, 58 (57%) children were off steroids and a significant fall in steroid threshold for relapse was noted (median 0.6; IQR 0.4–0.9 to median 0.3; IQR 0.12 - 0.5 mg/kg/alternate day, p=0.005). Anthropometric parameters (BMI SDS: 0.92±1.8 to 0.25±1.47, p=0.003; weight SDS: 0.20±1.6 to −0.11±1.3, p=0.01; and height SDS: −0.93±1.88 to −0.45±1.54, p=0.04) as well as obesity (38% to 20%, p=0.003) and short stature (11% to 3%, p=0.02) improved. Results remained significant even when analysis was restricted to children ≤12 years (n=88), (BMI SDS: 0.97±1.98 to 0.25±1.5, p=0.001; weight SDS: 0.33±1.6 to 0.02±1.2, p=0.01; and height SDS: −0.67±1.84 to −0.186±1.42, p=0.001).ConclusionsUse of rituximab resulted in significant steroid sparing effect with an improvement in both growth and obesity parameters.

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