Glucocorticoids and Risk of Venous Thromboembolism in Asthma Patients Aged 20–59 Years in the United Kingdom’s CPRD 1995–2015

Ayodele, Olulade; Cabral, Howard; McManus, David D.; Jick, Susan S.

doi:10.2147/clep.s341048

Cited by 13 publications

(4 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data addressing the short-and long-term adverse effects of corticosteroids are also limited; infectious complications could not be systematically evaluated, and there is low-to very low-certainty evidence for other safety outcomes. Additionally, previous studies assessing the use of corticosteroids for varied indications have demonstrated the potential for harm even when used in short courses (36,37).…”

Section: Recommendations For Specific Treatment Questionsmentioning

confidence: 99%

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline

Qadir,

Sahetya,

Munshi

et al. 2024

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Background: This document updates previously published Clinical Practice Guidelines for the management of patients with acute respiratory distress syndrome (ARDS), incorporating new evidence addressing the use of corticosteroids, venovenous extracorporeal membrane oxygenation, neuromuscular blocking agents, and positive end-expiratory pressure (PEEP).Methods: We summarized evidence addressing four "PICO questions" (patient, intervention, comparison, and outcome). A multidisciplinary panel with expertise in ARDS used the Grading of Recommendations, Assessment, Development, and Evaluation framework to develop clinical recommendations.Results: We suggest the use of: 1) corticosteroids for patients with ARDS (conditional recommendation, moderate certainty of evidence), 2) venovenous extracorporeal membrane oxygenation in selected patients with severe ARDS (conditional recommendation, low certainty of evidence), 3) neuromuscular blockers in patients with early severe ARDS (conditional recommendation, low certainty of evidence), and 4) higher PEEP without lung recruitment maneuvers as opposed to lower PEEP in patients with moderate to severe ARDS (conditional recommendation, low to moderate certainty), and 5) we recommend against using prolonged lung recruitment maneuvers in patients with moderate to severe ARDS (strong recommendation, moderate certainty).Conclusions: We provide updated evidence-based recommendations for the management of ARDS. Individual patient and illness characteristics should be factored into clinical decision making and implementation of these recommendations while additional evidence is generated from much-needed clinical trials.

show abstract

Section: Recommendations For Specific Treatment Questionsmentioning

confidence: 99%

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline

Qadir,

Sahetya,

Munshi

et al. 2024

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“… 5 Nevertheless, numerous patients progress to the state of respiratory failure, despite receiving optimal treatment throughout the disease course, resulting in increased mortality. Additionally, previous studies 6 assessing the use of corticosteroids for varied indications have demonstrated the potential for harm even when used in short courses. Regarding the recommended dose of corticosteroids for clinical workers to administer to patients, studies have reported different outcomes.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of corticosteroid administration for acute respiratory distress syndrome in adults based on meta-analyses and trial sequential analysis

Wu,

Li,

Dong

et al. 2024

Ann Saudi Med

View full text Add to dashboard Cite

BACKGROUND: Acute respiratory distress syndrome (ARDS), which results in lung injury as a consequence of sepsis and septic shock, is associated with severe systemic inflammation and is responsible for a high worldwide mortality rate. OBJECTIVE: Investigate whether corticosteroids could benefit clinical outcomes in adult with ARDS. METHODS: A comprehensive search of electronic databases Ovid MEDLINE, Ovid EMbase, and Cochrane Library from their inception to 7 May 2023 was conducted to identify studies that met the eligibility criteria, including only randomized controlled trials. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the methods of trial sequential analysis. MAIN OUTCOME MEASURES: Mortality rates, including including the 14-, 28-, 45-, and 60-day mortality, hospital mortality, and intensive care unit (ICU) mortality. SAMPLE SIZE: 17 studies with 2508 patients. RESULTS: Data relating to mortality at 14, 28, 45, and 60 days were not significantly different when treatments with corticosteroids and placebo were compared. In terms of hospital and ICU mortality, the mortality of those who had received corticosteroids was significantly lower than that of those who had not. ARDS patients who received assisted ventilation benefited from corticosteroid therapy, as revealed by the significant difference in outcome days between those who received assisted ventilation and those who did not. Corticosteroid had significantly more days free from mechanical ventilation, ICU-free days, and MODS-free days during the first 28 days, but not more organ support-free days up to day 28. CONCLUSION: Although corticosteroid therapy did not reduce mortality rates at different observation periods, it significantly reduced hospital and ICU mortality. Administering corticosteroids to ARDS patients significantly decreased the days of assisted ventilation and time cost consumption. This study confirmed that long-term use of low-dose glucocorticoids may have a positive effect on early ARDS. LIMITATION: Risk of bias due to the differences in patient characteristics.

show abstract

“…Inhaled corticosteroids have been the most widely used anti-inflammatory agents in asthma. Nevertheless, their efficacy may be limited by intrinsic or acquired resistance [ 6 ], and long-term use of corticosteroids is associated with adverse effects, such as bone comorbidities and venous thromboembolism [ 7 , 8 ]. Thus, identifying the precise molecular mechanisms of asthma that can be targeted therapeutically is in urgent requirement.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway

Zhou

Wang

et al. 2023

Mediators of Inflammation

View full text Add to dashboard Cite

Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.

show abstract

Glucocorticoids and Risk of Venous Thromboembolism in Asthma Patients Aged 20–59 Years in the United Kingdom’s CPRD 1995–2015

Cited by 13 publications

References 30 publications

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline

An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline

Clinical outcomes of corticosteroid administration for acute respiratory distress syndrome in adults based on meta-analyses and trial sequential analysis

Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway

Contact Info

Product

Resources

About