Latest & greatest articles for corticosteroids

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Top results for corticosteroids

821. Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma. Full Text available with Trip Pro

Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma. Inhaled corticosteroids are the cornerstone of anti-inflammatory asthma treatment. Anti-leukotrienes agents are currently being studied as alternative first line agents in the management of mild to moderate chronic asthma.The aims of this review study are to compare the safety and efficacy of anti-leukotriene agents with inhaled glucocorticoids and to determine the dose-equivalence (...) of anti-leukotrienes in mcg of inhaled corticosteroids in the management of chronic asthma.The searched Medline (1966 to 1999), Embase (1980 to 1999), Cinahl (1982 to 1999) and reference lists of review articles and trials; we contacted colleagues and international headquarters of anti-leukotrienes producers.Randomised controlled trials were included if they compared leukotriene antagonists with inhaled corticosteroids during a minimal 30-day intervention period in asthmatic patients aged 2 years

2000 Cochrane

822. Early emergency department treatment of acute asthma with systemic corticosteroids. Full Text available with Trip Pro

Early emergency department treatment of acute asthma with systemic corticosteroids. The airway edema and secretions associated with acute asthma are most effectively treated with anti-inflammatories such as corticosteroids delivered by inhaled, oral, intravenous or intra-muscular routes. There is an unresolved debate about the use of systemic corticorticoids in the early treatment of acute asthma for emergency department patients.To determine the benefit of treating patients with acute asthma (...) with systemic corticosteroids within an hour of presenting to the emergency department (ED).Randomised controlled trials were identified from the Cochrane Airways Group Asthma Register. Primary authors and content experts were contacted to identify eligible studies. Bibliographies from included studies and known reviews were searched.Only randomised controlled trials (RCTs) or quasi-randomised trials were eligible for inclusion. Studies were included if patients presenting to the ED with acute asthma were

2000 Cochrane

823. Corticosteroids for acute traumatic brain injury. (Abstract)

Corticosteroids for acute traumatic brain injury. Traumatic brain injury is a leading cause of death and disability. Corticosteroids have been widely used in treating people with traumatic brain injury.To quantify the effectiveness and safety of corticosteroids in the treatment of acute traumatic brain injury.Electronic sources: MEDLINE, EMBASE, Cochrane Library and specialised database searches. Additional hand searching and contact with trialists. Date of the most recent search June 1999.All (...) randomized controlled trials of corticosteroid use in acute traumatic brain injury with adequate or unclear allocation concealment.Quality of allocation concealment was scored. Data on numbers of participants randomized, numbers lost to follow up, length of follow up, case fatality rates, disablement, infections and gastrointestinal bleeds were extracted independently and checked.We identified 19 trials with 2295 randomized participants. The effect of corticosteroids on the risk of death was reported

2000 Cochrane

824. Inhaled corticosteroids for cystic fibrosis. Full Text available with Trip Pro

Inhaled corticosteroids for cystic fibrosis. Maintenance of optimal lung function is an important therapeutic goal in cystic fibrosis as it is lung damage that, in the long term, is responsible for most premature death among affected people. Inhaled corticosteroids are being increasingly used to treat children and adults with cystic fibrosis. The rationale for their use is that they have the potential to reduce lung damage arising from inflammation. However chronic use of inhaled steroids may (...) also have adverse effects. It is thus important to establish the current level of evidence about the potential benefits and harms of this practice.The objective of this review is to assess the effectiveness of regular use of inhaled corticosteroids when compared to no inhaled corticosteroids, in the management of patients with cystic fibrosis.Trials were ascertained from the Cochrane Cystic Fibrosis and Genetic Disorders Specialised Register of Controlled Trials which includes published

2000 Cochrane

825. Corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. (Abstract)

Corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Acute exacerbations occur quite commonly in patients with chronic obstructive pulmonary disease (COPD). Corticosteroid drugs, either parenteral or oral, are used commonly in this setting.To determine the effect of corticosteroids, administered either parenterally or orally, on the outcome in patients with acute exacerbations of COPD.An initial search was carried out using the Cochrane Airways Group COPD register (...) with additional studies sought in the bibliographies of randomised controlled trials and review articles. Authors of identified randomised controlled trials were contacted for other published and unpublished studies.Randomised controlled trials comparing corticosteroids, administered either parenterally or orally, with appropriate placebo. Other interventions were standardised e.g. bronchodilators, antibiotics. Studies of acute asthma were excluded.Data was extracted by one reviewer and sent to authors

2000 Cochrane

826. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. (Abstract)

Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Corticosteroids are often used to improve the rate of recovery from acute exacerbation in multiple sclerosis (MS) patients. However, it is still unclear just how relatively effective these agents are and the type of drug, optimal dose, frequency, duration of treatment and route of administration are unknown.The object of this review was to determine the efficacy and safety of corticosteroids or ACTH in reducing the short (...) and long term morbidity from MS. Moreover, we wished to examine from indirect comparisons if the effect of corticosteroids is different according to different doses and drugs, routes of administration, length of treatment.A search strategy developed for the Cochrane MS Group (last searched: June 1999) completed with handsearching and personal contacts with trialists and pharmaceutical companies was used.All randomised, double-blind, unconfounded trials comparing corticosteroids or ACTH to placebo

2000 Cochrane

827. Corticosteroids for maintaining remission of Crohn's disease. (Abstract)

Corticosteroids for maintaining remission of Crohn's disease. To evaluate the effectiveness and safety of conventional systemic corticosteroid therapy in maintaining clinical remission in Crohn's disease.A computer-assisted search of the on-line bibliographic database MEDLINE of studies published in English, French, Spanish, Italian and German between 1966 and May, 1998. Manual searches of the reference lists from the potentially relevant studies were performed in order to identify additional (...) or by the presence of no symptoms or only mild symptoms at the time of entry into the trial. The experimental treatment consisted of oral conventional corticosteroid therapy (excluding budesonide, fluticasone, etc). Clinical disease relapse was used as the outcome measure of interest.Eligible studies were selected by 4 reviewers and data were extracted onto standardized data extraction forms. Disagreements in eligibility or data extraction were resolved by consensus. Data were converted into individual 2x2

2000 Cochrane

828. Corticosteroids for acute ischaemic stroke. (Abstract)

Corticosteroids for acute ischaemic stroke. Much of the brain swelling in ischaemic stroke is due to cytotoxic oedema, which is related to cell membrane dysfunction. Early treatment with corticosteroids may help reduce the swelling and improve the outcomes after a stroke.The objective of this review was to assess the effect of corticosteroids in acute presumed ischaemic stroke.We searched the Cochrane Stroke Group trials register and contacted investigators in the field.Published randomised (...) trials comparing corticosteroids with placebo or control in people with acute (presumed or definite) ischaemic stroke. Trials were included if treatment began within 48 hours of stroke onset and if clinical outcome was assessed.Two reviewers independently applied the inclusion criteria, assessed trial quality and extracted the data.Seven trials involving 453 people were included. Details of trial quality that may relate to bias were not available from most trials. No difference was shown in the odds

2000 Cochrane

829. Corticosteroids for acute severe asthma in hospitalised patients. (Abstract)

Corticosteroids for acute severe asthma in hospitalised patients. Corticosteroids are currently used routinely in the management of acute severe asthma. The optimal dose and route of administration continues to be debated. Some investigators have reported a greater benefit of higher doses of corticosteroids in the management of severe asthma, while others have not.To determine whether higher doses of systemic corticosteroids (oral, intravenous or intramuscular) are more effective than lower (...) , included patients with acute severe asthma, compared different doses of corticosteroids (any route) in 2 or more treatment arms, and had a minimum period of follow up of 24 hours. Two reviewers independently assessed the studies for inclusion and disagreement was resolved by third party adjudication.Data were extracted independently by two reviewers if the authors were unable to verify the validity of information. Missing data were obtained from authors or calculated from other data presented

2000 Cochrane

830. Corticosteroids for preventing relapse following acute exacerbations of asthma. (Abstract)

Corticosteroids for preventing relapse following acute exacerbations of asthma. Acute asthma is responsible for many emergency department visits annually. Between 12-16% will relapse to require additional interventions within two weeks of ED discharge. Treatment of acute asthma is based on rapid reversal of bronchospasm and reducing airway inflammation and this review examines the evidence for using systemic corticosteroids to improve outcomes after discharge from the ED.To determine (...) the benefit of corticosteroids (oral, intramuscular, or intravenous) for the treatment of asthmatic patients discharged from an acute care setting (i.e. usually the emergency department) after assessment and treatment of an acute asthmatic exacerbation.The Cochrane Airways Group "Asthma and Wheez* RCT" register was searched using the terms: a) Asthma OR Wheez* b) Glucocorticoid OR Steroid* AND c) Exacerbat* OR Relapse* OR Emerg*. In addition, authors of all included studies were contacted to determine

2000 Cochrane

831. Prophylactic corticosteroids for preterm birth. (Abstract)

Prophylactic corticosteroids for preterm birth. Respiratory distress syndrome is a serious complication of prematurity causing significant immediate and long-term mortality and morbidity.The objective of this review was to assess the effects of corticosteroids administered to pregnant women to accelerate fetal lung maturity prior to preterm delivery.The Cochrane Pregnancy and Childbirth Group trials register was searched.Randomised and quasi-randomised trials of corticosteroid drugs capable (...) preterm was associated with a significant reduction in mortality (odds ratio 0.60, 95% confidence interval 0.48 to 0.75), respiratory distress syndrome (odds ratio 0.53, 95% confidence interval 0.44 to 0.63) and intraventricular haemorrhage in preterm infants. These benefits extended to a broad range of gestational ages and were not limited by gender or race. No adverse consequences of prophylactic corticosteroids for preterm birth have been identified.Corticosteroids given prior to preterm birth

2000 Cochrane

832. Calcitonin for the treatment and prevention of corticosteroid-induced osteoporosis. (Abstract)

Calcitonin for the treatment and prevention of corticosteroid-induced osteoporosis. Corticosteroid-induced osteoporosis is a cause of morbidity in patients with chronic obstructive lung disease, asthma, and rheumatologic disorders. Corticosteroid treatment causes bone loss by a variety of complex mechanisms. It has been shown that bone mineral loss at the hip averages 14% in the first year after starting corticosteroid therapy.To review the efficacy of calcitonin (subcutaneous or nasal (...) ) for the treatment and prevention of corticosteroid-induced osteoporosis.We conducted a search of Medline, the Cochrane Controlled Trials Register and Embase using the Cochrane Musculoskeletal Group search strategy for randomized controlled trials (RCTs) up to May 1998. We also searched bibliographic references and consulted content experts.Two independent reviewers selected RCTs which met predetermined inclusion criteria.Two reviewers independently extracted data using predetermined forms and assessed

2000 Cochrane

833. Calcium and vitamin D for corticosteroid-induced osteoporosis. (Abstract)

Calcium and vitamin D for corticosteroid-induced osteoporosis. To assess the effects of calcium and vitamin D compared to calcium alone or placebo in the prevention of bone loss in patients taking systemic corticosteroids.We searched the Cochrane Musculoskeletal trials register, Cochrane Controlled Trials Register, EMBASE and Medline up to 1996. We also conducted a hand search of abstracts from various scientific meetings and reference lists of selected trials.All randomized trials comparing (...) ), and radial bone mineral density (WMD 2.5 (95% CI 0.6, 4.4). The other outcome measures (femoral neck bone mass, fracture incidence, biochemical markers of bone resorption) were not significantly different.This meta-analysis demonstrated a clinically and statistically significant prevention of bone loss at the lumbar spine and forearm with vitamin D and calcium in corticosteroid treated patients. Because of low toxicity and cost all patients being started on corticosteroids should receive prophylactic

2000 Cochrane

834. Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. (Abstract)

Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Corticosteroids have been used late in the neonatal period to treat chronic lung disease (CLD) in preterm babies and early to try to prevent it. CLD is likely to be the result of persisting inflammation in the lung and the use of powerful anti-inflammatory drugs like dexamethasone has some rationale. Early use tends to be associated with increased adverse effects so that studies (...) of moderately early treatment (7-14 days postnatal) might have the dual benefits of fewer side effects and onset of action before chronic inflammation is established.To determine if moderately early (7-14 days) postnatal corticosteroid treatment vs control (placebo or nothing) is of benefit in the prevention and/or treatment of early chronic lung disease in the preterm infant.Randomised controlled trials of postnatal corticosteroid therapy were sought from the Oxford Database of Perinatal Trials, Cochrane

2000 Cochrane

835. Moderate-term, low-dose corticosteroids for rheumatoid arthritis. (Abstract)

Moderate-term, low-dose corticosteroids for rheumatoid arthritis. To perform a systematic review of low-dose corticosteroid efficacy in the moderate term for the treatment of rheumatoid arthritis (RA).We conducted a search in MEDLINE from 1966 to 1998, using the keywords "corticosteroids" and "rheumatoid arthritis". We also handsearched all issues of Arthritis and Rheumatism and the Scandinavian Journal of Rheumatology from their dates of first publication to 1994. Furthermore, we examined all (...) , or erythrocyte sedimentation rate (ESR). We also required that trials be of at least three months duration and use prednisone (or a comparable corticosteroid preparation) at a mean dosage of less than or equal to 15 mg/day. We included studies that used either placebo or active drug controls (i.e., comparative studies).We compared the effectiveness of prednisone to placebo and/or active controls using a fixed effects model for continuous data. A chi square test for homogeneity was performed, and where

2000 Cochrane

836. Delayed (>3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants. (Abstract)

Delayed (>3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants. Many preterm babies who survive, having had respiratory distress syndrome (RDS) or not, go on to develop chronic lung disease (CLD). This is probably due to persistence of inflammation in the lung. Corticosteroids have powerful anti-inflammatory effects and have been used to treat established CLD. However it is unclear whether any beneficial effects outweigh the adverse effects of these drugs.To (...) determine if late (> 3 weeks) postnatal corticosteroid treatment vs control (placebo or nothing) is of benefit in the treatment of chronic lung disease (CLD) in the preterm infant.Randomised controlled trials of postnatal corticosteroid therapy were sought from the Oxford Database of Perinatal Trials, the Cochrane Database of Controlled Trials, Medline, hand searching paediatric and perinatal journals, examining previous review articles and information received from practising neonatologists.Randomised

2000 Cochrane

837. Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates. (Abstract)

Early administration of inhaled corticosteroids for preventing chronic lung disease in ventilated very low birth weight preterm neonates. Chronic lung disease remains a common complication amongst preterm infants. There is increasing evidence that inflammation play an important role in the pathogenesis of CLD. Due to their strong anti-inflammatory properties corticosteroids is an attractive intervention strategy. However, there are growing concerns regarding short and long term effects (...) of systemic corticosteroids. Theoretically, administration of inhaled corticosteroids may allow for beneficial effects on the pulmonary system with a lower risk of undesirable systemic side effects.To determine the impact of inhaled corticosteroids administered to ventilated very low birth weight preterm neonates in the first two weeks of life for the prevention of chronic lung disease(CLD).Systematic search in accordance with Cochrane Neonatal Review Group. Randomized and quasi-randomized trials were

2000 Cochrane

838. Systemic adverse effects of inhaled corticosteroid therapy: a systematic review and meta-analysis

Systemic adverse effects of inhaled corticosteroid therapy: a systematic review and meta-analysis Systemic adverse effects of inhaled corticosteroid therapy: a systematic review and meta-analysis Systemic adverse effects of inhaled corticosteroid therapy: a systematic review and meta-analysis Lipworth B J Authors' objectives To appraise the systemic adverse effects of inhaled corticosteroids. Searching The authors searched the MEDLINE, EMBASE and BIDS electronic databases (January 1, 1966 (...) and questionnaires. Some of the RCTs were open and/or crossover in design. Only 13 of the studies were double-blinded. Specific interventions included in the review The authors stated an a priori intention to look at inhaled corticosteroids. The studies included in the review looked at both inhaled and oral corticosteroids. Interventions included inhaled corticosteroids (triamcinolone acetonide, fluticasone propionate, budesonide, beclomethasone dipropionate, or flunisolide), and salmeterol xinafoate, cromolyn

1999 DARE.

839. The role of vitamin D in corticosteroid-induced osteoporosis: a meta-analytic approach

The role of vitamin D in corticosteroid-induced osteoporosis: a meta-analytic approach The role of vitamin D in corticosteroid-induced osteoporosis: a meta-analytic approach The role of vitamin D in corticosteroid-induced osteoporosis: a meta-analytic approach Amin S, LaValley M P, Simms R W, Felson D T Authors' objectives To determine if vitamin D is more effective than no therapy of calcium alone in the management of corticosteroid-induced osteoporosis, and to determine how vitamin D compares (...) within the first 6 months of starting corticosteroid therapy. Studies that randomised participants using alternate allocation to treatment were excluded. Specific interventions included in the review In the first meta-analysis vitamin D plus calcium, or vitamin D alone, were compared against no therapy, placebo or calcium alone. In the second meta-analysis vitamin D plus calcium, or vitamin D alone, were compared against bisphosphonates (e.g. alendronate, etidronate), calcitonin, fluoride (e.g

1999 DARE.

840. Corticosteroids in the emergency department therapy of acute adult asthma: an evidence-based evaluation

Corticosteroids in the emergency department therapy of acute adult asthma: an evidence-based evaluation Corticosteroids in the emergency department therapy of acute adult asthma: an evidence-based evaluation Corticosteroids in the emergency department therapy of acute adult asthma: an evidence-based evaluation Rodrigo G, Rodrigo C Authors' objectives To determine the effectiveness of corticosteroids (CCSs) (oral, IM, IV or inhaled) in the treatment of adult patients with acute asthma. Searching (...) included in the review Randomised controlled trials (RCTs) conducted in an emergency care setting. Specific interventions included in the review Corticosteroids (CCSs) (hydrocortisone (HYD), methylprednisolone, or flunisolide with HYD equivalents ranging from 8.3 to 300.0 mg/kg/24 hours) administered either orally, intramuscularly, intravenously, or by inhalation) with a co-intervention of aminophylline for the intervention groups, and placebo for the control groups. Participants included in the review

1999 DARE.