A Review on the Safety and Efficacy of Inhaled Corticosteroids in the Management of Asthma

Ye, Qian; He, Xiao-Ou; D’Urzo, Anthony

doi:10.1007/s41030-017-0043-5

Cited by 64 publications

(51 citation statements)

References 144 publications

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“…[37][38][39] It is best practice to review ICS dose and use the lowest dose possible to maintain asthma control. 40 We also found that the rise in OCS cost was mainly driven by a steep increase in price of hydrocortisone tablets from 2008 onwards; and BP prescribing went up as BP cost went down after 2005.…”

Section: Discussionmentioning

confidence: 58%

A retrospective database study of oral corticosteroid and bisphosphonate prescribing patterns in England

Chalitsios

Shaw

McKeever

2020

npj Prim. Care Respir. Med.

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Exposure to oral corticosteroids (OCS) is associated with an increased risk of osteoporosis and fragility fractures. Guidelines suggest bisphosphonate (BP) therapy as the first-line treatment of glucocorticoid-induced osteoporosis (GIOP). This population study used publicly available data, including prescription annual cost analysis and monthly practice-level data. Our aim was to examine the prescribing of OCS and BP at practice level and investigate reasons for variation using a mixed-effect negative binomial regression analysis. There was a rise in OCS and BP prescriptions of 55% and 1200% from 1998 to 2018, respectively. Of the 6586 included practices, the median (IQR) of OCS and BP prescriptions were 120.8 (84.8-160.4) and 107.7 (73.8-147.4) per 1000 patients, respectively. Asthma and chronic obstructive pulmonary disease (COPD) were significantly associated with OCS use (p < 0.0001), but only COPD was associated with BP use (p < 0.0001). Higher OCS prescribing rates were associated with higher BP prescribing rates (5th to 1st quintile-IRR = 1.99; 95% CI: 1.88-2.10). Practice list size, deprivation and advanced age were all associated with both drugs (p < 0.0001). In conclusion, although OCS use is positively associated with BP prescription, variation among practices and CCGs exists. The variation in prescribing suggests there is still a need to improve GIOP prevention.

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Section: Discussionmentioning

confidence: 58%

A retrospective database study of oral corticosteroid and bisphosphonate prescribing patterns in England

Chalitsios

Shaw

McKeever

2020

npj Prim. Care Respir. Med.

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“…The use of high doses of ICS for prolonged periods increases the risk of systemic adverse effects, such as reduction of bone mineral density, respiratory infections (including tuberculosis), cataracts, glaucoma, and suppression of the hypothalamic-pituitary-adrenal axis. (1,(36)(37)(38)(39)…”

Section: Icsmentioning

confidence: 99%

2020 Brazilian Thoracic Association recommendations for the management of asthma

et al. 2020

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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.

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“…Prevalensi dan keparahan penyakit alergi terus meningkat secara global, terutama di negara dengan pendapatan rendah sampai menengah 1 . Penggunaan terapi alergi jangka panjang selain dapat menyebabkan efek samping berupa sindroma Cushing juga membebani penderita dari segi ekonomi 2 . Daun jambu biji (Psidium guajava) secara tradisional digunakan untuk mengobati inflamasi, diabetes, hipertensi, luka, nyeri, dan demam 3 .…”

Section: Pendahuluanunclassified

Efek Anti Histamin Ekstrak Daun Jambu Biji Pada Tikus Putih Yang Diinduksi Ovalbumin Dinilai Dari Jumlah Eosinofil Jaringan Kulit

2020

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ABSTRAKPendahuluan: Prevalensi dan keparahan penyakit alergi terus meningkat secara global, terutama di negara dengan pendapatan rendah sampai menengah. Terapi alergi saat ini seperti kortikosteroid banyak memberikan efek samping dalam penggunaan jangka panjang. Ekstrak daun jambu biji (Psidium guajava) berpotensi sebagai antihistamin yang dapat menjadi terapi alternatif penyakit alergi. Penelitian ini bertujuan untuk mengetahui efek antihistamin ekstrak daun jambu biji (Psidium guajava) pada tikus putih (Rattus novergicus) yang diinduksi ovalbumin dinilai dari jumlah eosinofil jaringan kulit. Metode: Penelitian ini merupakan penelitian quasi experimental design dengan rancangan post test only with control group design. Subjek penelitian tikus putih jantan, umur 3-4 bulan, dan berat badan 200-300 gram. Sampel 24 ekor tikus putih dibagi secara random menjadi enam kelompok. Kelompok kontrol normal (K) tanpa perlakuan, kontrol negatif (KN) hanya diinduksi ovalbumin, kontrol positif (KP) diberikan metilprednisolon, dan kelompok perlakuan (KP1, KP2, KP3) diberikan ekstrak daun jambu biji dengan dosis berikut 27 mg/200 gramBB, 54 mg/200 gramBB, dan 108 mg/200 gramBB. Efek antihistamin dinilai melalui gambaran histopatologi jaringan kulit berupa rata-rata jumlah infiltrasi eosinofil dengan menggunakan mikroskop cahaya. Data dianalisis menggunakan uji Kruskal Wallis dan dilanjutkan uji Post Hoc Mann Whitney (α= 0,05).Hasil: Uji Kruskal Wallis menunjukkan perbedaan signifikan di antara enam kelompok perlakuan (p=0,00). Uji Post Hoc Mann Whitney menunjukkan perbedaan signifikan di antara semua pasangan kelompok (p=<0,05). KP3 menunjukkan rerata jumlah eosinofil lebih rendah daripada KP dan signifikan (p=0,021). Kesimpulan: Ekstrak daun jambu biji (Psidium guajava) memiliki efek antihistamin dengan menurunkan infiltrasi eosinofil pada jaringan kulit tikus putih (Rattus norvegicus) yang dinduksi ovalbumin.Kata Kunci: Ekstrak daun jambu biji, eosinofil, tikus putih, histopatologi kulit. ABSTRACTIntroduction: The prevalence and severity of allergic diseases continues to increase globally, especially in countries with low to middle income. Current allergic therapies such as corticosteroids have many side effects in long-term use. Guava leaf extract (Psidium guajava) has the potential as an antihistamine which can be an alternative therapy for allergic diseases. This study aims to determine the effect of antihistamine extract of guava leaves (Psidium guajava) on white rats (Rattus novergicus) induced by ovalbumin assessed from the number of eosinophils of skin tissue. Methods: This research was a quasi experimental design with a post test only design with control group design. The research subjects were male white rats, aged 3-4 months, and weighing 200-300 grams. Samples of 24 white rats were randomly divided into six groups. Normal (K) control group without treatment, negative control (KN) was only induced by ovalbumin, positive control (KP) was given methylprednisolone, and treatment groups (KP1, KP2, KP3) were given guava leaf extract with the following dosage 27 mg / 200 gram BW, 54 mg / 200 gram BW, and 108 mg / 200 gram BW. The effect of antihistamines was assessed through histopathology of skin tissue in the form of an average number of eosinophil infiltrations using a light microscope. Data were analyzed using the Kruskal Wallis test and followed by the Mann Whitney Post Hoc test (α = 0.05).Result: The Kruskal Wallis test showed significant differences between the six treatment groups (p = 0.00). The Mann Whitney Post Hoc test showed significant differences between all group pairs (p = <0.05). KP3 shows the average number of eosinophils lower than KP and significant (p = 0.021). Conclusion: Guava leaf extract (Psidium guajava) has an antihistamine effect by reducing eosinophil infiltration in ovalbumin-induced white rat (Rattus norvegicus) skin tissue.Keywords: Guava leaf extract; eosinophil; skin histopathology

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A Review on the Safety and Efficacy of Inhaled Corticosteroids in the Management of Asthma

Cited by 64 publications

References 144 publications

A retrospective database study of oral corticosteroid and bisphosphonate prescribing patterns in England

A retrospective database study of oral corticosteroid and bisphosphonate prescribing patterns in England

2020 Brazilian Thoracic Association recommendations for the management of asthma

Efek Anti Histamin Ekstrak Daun Jambu Biji Pada Tikus Putih Yang Diinduksi Ovalbumin Dinilai Dari Jumlah Eosinofil Jaringan Kulit

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