Intermittent vs Continuous Steroid Administration

Keller, Nancy R.

doi:10.1001/archopht.1976.03910030316013

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…There are several experimental models of allergic con junctivitis medi ated by active anaphylactic reaction in guinea pigs [Dwyer et a!., 1974] and rabbits [Keller et al, 1976]. These models are of great value, but they require numerous animals sensitized actively to evaluate the effect of various compounds.…”

Section: Introductionmentioning

confidence: 99%

Passive Anaphylaxis in Rat Conjunctiva and Topical Effects of Antiallergic Agents Hypersensitivity in Conjunctiva and Drug Efficacy

Iso¹,

Nakajima²,

Suda³

et al. 1980

Ophthalmic Res

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Homologous passive anaphylactic reaction mediated by a reaginic antibody was caused in rat conjunctiva and the effects of several drugs on this reaction were examined by estimating the leakage of dye in the tissue as a parameter of the increased vascular permeability during anaphylaxis. In this model, topical application of disodium cromoglycate did not produce any effect, while given intravenously marked inhibition was elicited. Other antiallergic drugs such as dexamethasone, mepyramine, epinephrine and glycyrrhizin were effective topically as well as systemically. On the other hand, indomethacin given orally and topically tended to enhance the reaction. Present results suggest that this model may be useful as a convenient method for screening of topical antiallergic drugs on the immediate ocular hypersensitivity reaction.

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Section: Introductionmentioning

confidence: 99%

Passive Anaphylaxis in Rat Conjunctiva and Topical Effects of Antiallergic Agents Hypersensitivity in Conjunctiva and Drug Efficacy

Iso¹,

Nakajima²,

Suda³

et al. 1980

Ophthalmic Res

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“…The latter was found to be the superior means of immunosuppression but the pumps required renewal after seven days. It has also been demonstrated that hydrocortisone acetate incorporated in a polypeptide matrix reduced xenograft-induced inflammation at total doses that were significantly less than those delivered by eye drops [21,22]. Subcutaneously implantable compressed steroid pellets have also been tested for the treatment of testosterone deficiency syndrome (ORETRON, Schering AG), adrenocortical deficiency (TEROCORTEN, Ciba) and prostate carcinoma (PROGYNON, Schering AG).…”

Section: Discussionmentioning

confidence: 99%

Sustained release of a corticosteroid using polymeric implants

et al. 1986

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An effective sustained release method of drug administration, using methylprednisolone incorporated into acrylic bone cement, has been developed. The effect of this form of treatment on peripheral blood leukocytes, lymphoid tissue weight and the inflammatory response has been evaluated. This mode of methylprednisolone administration was compared with conventional systemic therapy and was found to produce rapid and prolonged pharmacological effects at very low plasma levels of drug. A dose response relationship was established and we determined that, for a given quantity of drug, the level and duration of suppression was greater using sustained release therapy. The inflammatory response was also depressed using this mode of administration. These results, coupled with the commercial availability and existing clinical approval of SIMPLEX P bone cement, suggest that further development may lead to useful clinical protocols.

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“…Like antipsychotics in schizophrenia, the benefit/risk of intermittent vs continuous treatment with steroids is still debated, many decades after steroids has been available in clinical practice. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Targeted Treatment of Schizophrenia Symptoms as They Manifest, or Continuous Treatment to Reduce the Risk of Psychosis Recurrence

Davidson,

Carpenter

2023

Schizophrenia Bulletin

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Current pharmacological treatment of schizophrenia employs drugs that interfere with dopamine neurotransmission, aiming to suppress acute exacerbation of psychosis and maintenance treatment to reduce the risk of psychosis recurrence. According to this treatment scheme, available psychotropic drugs intended to treat negative symptoms, cognitive impairment, or anxiety are administered as add-ons to treatment with antipsychotics. However, an alternative treatment scheme proposes a targeted or intermittent treatment approach, by which antipsychotic drugs are administered upon psychosis exacerbation and discontinued upon remission or stabilization, while negative symptoms, cognitive impairment, or anxiety are treated with specific psychotropics as monotherapy. Along these lines, antipsychotics are renewed only in the event of recurrence of psychotic symptoms. This 50-year-old debate between targeted and continuous treatment schemes arises from disagreements about interpreting scientific evidence and discordant views regarding benefit/risk assessment. Among the debate’s questions are: (1) what is the percentage of individuals who can maintain stability without antipsychotic maintenance treatment, and what is the percentage of those who exacerbate despite antipsychotic treatment? (2) how to interpret results of placebo-controlled 9- to 18-month-long maintenance trials in a life-long chronic disorder, and how to interpret results of the targeted trials, some of which are open label or not randomized; (3) how to weigh the decreased risk for psychotic recurrence vs the almost certainty of adverse effects on patient’s quality of life. Patients’ profiles, preferences, and circumstances of the care provision should be considered as the targeted vs continuous treatment options are considered.

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Intermittent vs Continuous Steroid Administration

Cited by 8 publications

References 7 publications

Passive Anaphylaxis in Rat Conjunctiva and Topical Effects of Antiallergic Agents Hypersensitivity in Conjunctiva and Drug Efficacy

Passive Anaphylaxis in Rat Conjunctiva and Topical Effects of Antiallergic Agents Hypersensitivity in Conjunctiva and Drug Efficacy

Sustained release of a corticosteroid using polymeric implants

Targeted Treatment of Schizophrenia Symptoms as They Manifest, or Continuous Treatment to Reduce the Risk of Psychosis Recurrence

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