Dose-response relationship for risk of non-vertebral fracture with inhaled corticosteroids

2008 ◽  
Vol 38 (9) ◽  
pp. 1451-1458 ◽  
Author(s):  
M. Weatherall ◽  
K. James ◽  
J. Clay ◽  
K. Perrin ◽  
M. Masoli ◽  
...  
2019 ◽  
Vol 55 (1) ◽  
pp. 1901147 ◽  
Author(s):  
Ingrid Maijers ◽  
Nethmi Kearns ◽  
James Harper ◽  
Mark Weatherall ◽  
Richard Beasley

BackgroundThe proportion of the efficacy of high-dose inhaled corticosteroids (ICS) in oral corticosteroid-dependent asthma that is due to systemic effects is uncertain. This study aimed to estimate the ICS dose–response relationship for oral corticosteroid-sparing effects in oral corticosteroid-dependent asthma, and to determine the proportion of oral corticosteroid-sparing effects due to their systemic effects, based on the comparative dose–response relationship of ICS versus oral corticosteroids on adrenal suppression.MethodsSystematic review and meta-analysis of randomised controlled trials reporting oral corticosteroid-sparing effects of high-dose ICS in oral corticosteroid-dependent asthma. In addition, reports of oral corticosteroid to ICS dose-equivalence in terms of adrenal suppression were retrieved. The primary outcome was the proportion of the oral corticosteroid-sparing effect of ICS that could be attributed to systemic absorption, per 1000 µg increase of ICS, expressed as a ratio. This ratio estimates the oral corticosteroid sparing effect of ICS due to systemic effects.Results11 studies including 1283 participants reporting oral corticosteroid-sparing effects of ICS were identified. The prednisone dose decrease per 1000 µg increase in ICS varied from 2.1 mg to 4.9 mg, depending on the type of ICS. The ratio of the prednisone-sparing effect due to the systemic effects per 1000 µg of fluticasone propionate was 1.02 (95% CI 0.68–2.08) and for budesonide was 0.93 (95% CI 0.63–1.89).ConclusionIn patients with oral corticosteroid-dependent asthma, the limited available evidence suggests that the majority of the oral corticosteroid-sparing effect of high-dose ICS is likely to be due to systemic effects.


Respirology ◽  
2009 ◽  
Vol 14 (7) ◽  
pp. 983-990 ◽  
Author(s):  
Mark WEATHERALL ◽  
Jennifer CLAY ◽  
Kate JAMES ◽  
Kyle PERRIN ◽  
Philippa SHIRTCLIFFE ◽  
...  

2004 ◽  
Vol 4 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Matthew Masoli ◽  
Shaun Holt ◽  
Mark Weatherall ◽  
Richard Beasley

1962 ◽  
Vol 41 (2) ◽  
pp. 268-273 ◽  
Author(s):  
Ralph I. Dorfman

ABSTRACT The stimulating action of testosterone on the chick's comb can be inhibited by the subcutaneous injection of 0.1 mg of norethisterone or Ro 2-7239 (2-acetyl-7-oxo-1,2,3,4,4a,4b,5,6,7,9,10,10a-dodecahydrophenanthrene), 0.5 mg of cortisol or progesterone, and by 4.5 mg of Mer-25 (1-(p-2-diethylaminoethoxyphenyl)-1-phenyl-2-p-methoxyphenyl ethanol). No dose response relationship could be established. Norethisterone was the most active anti-androgen by this test.


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