Gold as an oral corticosteroid sparing agent in stable asthma

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

“…Treatments included: anti-leukotrienes [ 64 , 65 ]; beta-agonists (inhaled/non-inhaled) [ 61 - 63 , 66 - 75 ]; allergen immunotherapy [ 76 ]; anti-IgE [ 77 ]; antibiotics [ 78 ]; anti-cholinergics [ 57 ]; azathioprine [ 79 ]; beclomethasone [ 80 - 82 ]; budesonide [ 83 , 84 ]; caffeine [ 85 ]; beta-blockers [ 58 ]; chloroquine [ 86 ]; corticosteroids (inhaled/non-inhaled) [ 59 , 60 , 87 - 91 ]; cyclosporine [ 92 ]; fluticasone [ 93 - 96 ]; anti-gastro-oesophageal reflux treatment [ 97 ]; gold [ 98 ]; inhaled/non-inhaled magnesium sulphate [ 98 , 100 ]; macrolides [ 101 , 102 ]; methotrexate [ 103 ]; oxatomide [ 104 ]; and tailored interventions based on sputum eosinophils [ 105 ].…”

“…SABA, while generally less effective than LABA, showed in one review (49 trials) [ 70 ] that regular use of inhaled SABA can decrease symptoms and rescue medication. A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use.…”

“…A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use. Two trials found no evidence to indicate that either colchicines [ 106 ] or dapsone [ 107 ] were effective in the management of steroid dependent asthmatic patients.…”

“…Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [62,64-66,68,70-73,75,77,82-84,87,88,92,93,96,98,103-105]. …”

“…The emphasis in systematic reviews of pharmacological interventions for asthma is clearly on beta-agonists and corticosteroids, with the use of these for relevant asthma-related conditions and in combination with other appropriate pharmacological agents receiving wide support [ 59 , 60 , 62 , 69 , 71 - 75 , 88 , 91 , 96 ], though with some safety concerns [ 62 ]. Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [ 62 , 64 - 66 , 68 , 70 - 73 , 75 , 77 , 82 - 84 , 87 , 88 , 92 , 93 , 96 , 98 , 103 - 105 ].…”

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

“…Treatments included: anti-leukotrienes [ 64 , 65 ]; beta-agonists (inhaled/non-inhaled) [ 61 - 63 , 66 - 75 ]; allergen immunotherapy [ 76 ]; anti-IgE [ 77 ]; antibiotics [ 78 ]; anti-cholinergics [ 57 ]; azathioprine [ 79 ]; beclomethasone [ 80 - 82 ]; budesonide [ 83 , 84 ]; caffeine [ 85 ]; beta-blockers [ 58 ]; chloroquine [ 86 ]; corticosteroids (inhaled/non-inhaled) [ 59 , 60 , 87 - 91 ]; cyclosporine [ 92 ]; fluticasone [ 93 - 96 ]; anti-gastro-oesophageal reflux treatment [ 97 ]; gold [ 98 ]; inhaled/non-inhaled magnesium sulphate [ 98 , 100 ]; macrolides [ 101 , 102 ]; methotrexate [ 103 ]; oxatomide [ 104 ]; and tailored interventions based on sputum eosinophils [ 105 ].…”

“…SABA, while generally less effective than LABA, showed in one review (49 trials) [ 70 ] that regular use of inhaled SABA can decrease symptoms and rescue medication. A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use.…”

“…A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use. Two trials found no evidence to indicate that either colchicines [ 106 ] or dapsone [ 107 ] were effective in the management of steroid dependent asthmatic patients.…”

“…Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [62,64-66,68,70-73,75,77,82-84,87,88,92,93,96,98,103-105]. …”

“…The emphasis in systematic reviews of pharmacological interventions for asthma is clearly on beta-agonists and corticosteroids, with the use of these for relevant asthma-related conditions and in combination with other appropriate pharmacological agents receiving wide support [ 59 , 60 , 62 , 69 , 71 - 75 , 88 , 91 , 96 ], though with some safety concerns [ 62 ]. Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [ 62 , 64 - 66 , 68 , 70 - 73 , 75 , 77 , 82 - 84 , 87 , 88 , 92 , 93 , 96 , 98 , 103 - 105 ].…”

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

“…Treatments included: anti-leukotrienes [ 64 , 65 ]; beta-agonists (inhaled/non-inhaled) [ 61 - 63 , 66 - 75 ]; allergen immunotherapy [ 76 ]; anti-IgE [ 77 ]; antibiotics [ 78 ]; anti-cholinergics [ 57 ]; azathioprine [ 79 ]; beclomethasone [ 80 - 82 ]; budesonide [ 83 , 84 ]; caffeine [ 85 ]; beta-blockers [ 58 ]; chloroquine [ 86 ]; corticosteroids (inhaled/non-inhaled) [ 59 , 60 , 87 - 91 ]; cyclosporine [ 92 ]; fluticasone [ 93 - 96 ]; anti-gastro-oesophageal reflux treatment [ 97 ]; gold [ 98 ]; inhaled/non-inhaled magnesium sulphate [ 98 , 100 ]; macrolides [ 101 , 102 ]; methotrexate [ 103 ]; oxatomide [ 104 ]; and tailored interventions based on sputum eosinophils [ 105 ].…”

“…SABA, while generally less effective than LABA, showed in one review (49 trials) [ 70 ] that regular use of inhaled SABA can decrease symptoms and rescue medication. A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use.…”

“…A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use. Two trials found no evidence to indicate that either colchicines [ 106 ] or dapsone [ 107 ] were effective in the management of steroid dependent asthmatic patients.…”

“…Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [62,64-66,68,70-73,75,77,82-84,87,88,92,93,96,98,103-105]. …”

“…The emphasis in systematic reviews of pharmacological interventions for asthma is clearly on beta-agonists and corticosteroids, with the use of these for relevant asthma-related conditions and in combination with other appropriate pharmacological agents receiving wide support [ 59 , 60 , 62 , 69 , 71 - 75 , 88 , 91 , 96 ], though with some safety concerns [ 62 ]. Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [ 62 , 64 - 66 , 68 , 70 - 73 , 75 , 77 , 82 - 84 , 87 , 88 , 92 , 93 , 96 , 98 , 103 - 105 ].…”

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

“…Treatments included: anti-leukotrienes [ 64 , 65 ]; beta-agonists (inhaled/non-inhaled) [ 61 - 63 , 66 - 75 ]; allergen immunotherapy [ 76 ]; anti-IgE [ 77 ]; antibiotics [ 78 ]; anti-cholinergics [ 57 ]; azathioprine [ 79 ]; beclomethasone [ 80 - 82 ]; budesonide [ 83 , 84 ]; caffeine [ 85 ]; beta-blockers [ 58 ]; chloroquine [ 86 ]; corticosteroids (inhaled/non-inhaled) [ 59 , 60 , 87 - 91 ]; cyclosporine [ 92 ]; fluticasone [ 93 - 96 ]; anti-gastro-oesophageal reflux treatment [ 97 ]; gold [ 98 ]; inhaled/non-inhaled magnesium sulphate [ 98 , 100 ]; macrolides [ 101 , 102 ]; methotrexate [ 103 ]; oxatomide [ 104 ]; and tailored interventions based on sputum eosinophils [ 105 ].…”

“…SABA, while generally less effective than LABA, showed in one review (49 trials) [ 70 ] that regular use of inhaled SABA can decrease symptoms and rescue medication. A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use.…”

“…A modest effect has been shown with regards to antileukotrienes [ 64 ], allergen immunotherapy [ 76 ], cyclosporine [ 91 ], gold [ 98 ], and anticholinergics [ 57 ]. However, this modest effect in combination with serious adverse events and/or the need for close monitoring, make therapeutic options such as immunotherapy [ 74 ], cyclosporine [ 92 ] and gold [ 98 ], problematic and inappropriate for clinical use. Two trials found no evidence to indicate that either colchicines [ 106 ] or dapsone [ 107 ] were effective in the management of steroid dependent asthmatic patients.…”

“…Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [62,64-66,68,70-73,75,77,82-84,87,88,92,93,96,98,103-105]. …”

“…The emphasis in systematic reviews of pharmacological interventions for asthma is clearly on beta-agonists and corticosteroids, with the use of these for relevant asthma-related conditions and in combination with other appropriate pharmacological agents receiving wide support [ 59 , 60 , 62 , 69 , 71 - 75 , 88 , 91 , 96 ], though with some safety concerns [ 62 ]. Reviews that address the 'steroid-sparing' or rescue medication reduction features of various approaches to the pharmacological treatment of asthma are an important sub-group of studies, given the known side-effect profile of this class of drugs [ 62 , 64 - 66 , 68 , 70 - 73 , 75 , 77 , 82 - 84 , 87 , 88 , 92 , 93 , 96 , 98 , 103 - 105 ].…”