Skin Manifestations of Inhaled Corticosteroids in COPD Patients

Tashkin, Donald P.; Murray, H. Eileen; Skeans, M. A.; Murray, Robert P.

doi:10.1016/s0012-3692(15)31287-3

Cited by 50 publications

(30 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Inhaled steroid treatment for chronic lung disease also leads to a high incidence of bruising. 3 Intranasal topical steroid spray is associated with epistaxis in up to 23% of patients. 4 Spontaneous haemorrhage from subarachnoid aneurysms is more likely with chronic steroid treatment.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids

Mercieca

Sanghvi

Jones

2010

Eye

View full text Add to dashboard Cite

Purpose To investigate the observed high prevalence of spontaneous sub-conjunctival haemorrhage (SCH) in patients using long-term topical steroid treatment. Patients and methods A cross sectional survey of the occurrence of SCH was carried out in 248 patients using steroid eye drops and in a comparison group of 113 patients using topical glaucoma medication. Results Twenty-four patients with uveitis (10% of total) experienced single or recurrent SCH. Of these 71% used prednisolone acetate 1% (compared with 75% for those unaffected). None of 113 glaucoma patients were affected. Conclusions The long-term use of topical steroid for chronic uveitis substantially increases the prevalence of spontaneous or minimal-trauma SCH. Steroid-induced vascular fragility is the likely cause.

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids

Mercieca

Sanghvi

Jones

2010

Eye

View full text Add to dashboard Cite

show abstract

“…There was no difference in growth velocity in the 6 mo of our study among the pediatric patients who were on ICS compared with those who stopped. The Lung Health Study II has revealed that inhaled triamcinolone acetonide given to middle aged and elderly patients with mild to moderate COPD leads to an increased incidence of skin bruising and impaired skin healing, as well as loss of bone mineral density after 3 yr of treatment (30,31). Concern has been expressed about promotion of infection, due to an apparent increase in new P. aeruginosa acquisition, in an unpublished but well publicized small study of ICS that was halted prematurely (32); because of the small numbers and short time frame it is difficult to know whether the findings of this study were valid.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Randomized Controlled Trial of Withdrawal of Inhaled Corticosteroids in Cystic Fibrosis

Balfour‐Lynn

Lees²,

Hall³

et al. 2006

Am J Respir Crit Care Med

134

View full text Add to dashboard Cite

Rationale: Lung inflammation and injury is critical in cystic fibrosis. An ideal antiinflammatory agent has not been identified but inhaled corticosteroids are widely used despite lack of evidence. Objectives: To test the safety of withdrawal of inhaled corticosteroids with the hypothesis this would not be associated with an earlier onset of acute chest exacerbations. Methods: Multicenter randomized double-blind placebo-controlled trial in 18 pediatric and adult UK centers. Eligibility criteria included age Ͼ 6.0 yr, FEV 1 у 40% predicted, and corticosteroid use Ͼ 3 mo. During the 2-mo run-in period, all patients received fluticasone; they then took either fluticasone or placebo for 6 mo. Measurements and Main Results: Fluticasone group: n ϭ 84, median age 14.6 yr, mean (SD) FEV 1 76% (18); placebo group: n ϭ 87, median age 15.8 yr, mean (SD) FEV 1 76% (18). There was no difference in time to first exacerbation (primary outcome) with hazard ratio (95% confidence interval) of 1.07 (0.68 to 1.70) for fluticasone versus placebo. There was no effect of age, atopy, corticosteroid dose, FEV 1 , or Pseudomonas aeruginosa status. There was no change in lung function or differences in antibiotic or rescue bronchodilator use. Fewer patients in the fluticasone group withdrew from the study due to lung-related adverse events (9 vs. 15%); with a relative risk (95% confidence interval) of 0.59 (0.23-1.48) fluticasone versus placebo. Conclusions:In this study population (applicable to 40% of patients with cystic fibrosis in the UK), it appears safe to consider stopping inhaled corticosteroids. Potential advantages will be to reduce the drug burden on patients, reduce adverse effects, and make financial savings.

show abstract

“…There is a greater risk of easy bruising in elderly patients [135][136][137][138][139] and in women [135].…”

Section: Skin Thinning and Bruisingmentioning

confidence: 99%

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

D’Urzo

2017

Pulm Ther

View full text Add to dashboard Cite

Asthma is a chronic inflammatory disease characterized by symptoms of cough, dyspnea, chest tightness, and wheeze. Inhaled corticosteroids (ICS) have been recommended as initial therapy in the treatment of persistent asthma in all guidelines, as they have been shown to reduce morbidity and mortality. However, high-dose regimens and long-term use of ICS may be associated with a variety of side effects, similar to those observed with systemic corticosteroid therapy. These side effects include impaired growth in children, osteoporosis, fractures, glaucoma, cataracts, and skin thinning. The current recommendations on ICS use in asthma management will be reviewed in this article with a view to highlight treatment strategies that strike an optimal balance between safety and efficacy.

show abstract

Skin Manifestations of Inhaled Corticosteroids in COPD Patients

Cited by 50 publications

References 22 publications

Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids

Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids

Multicenter Randomized Controlled Trial of Withdrawal of Inhaled Corticosteroids in Cystic Fibrosis

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

Contact Info

Product

Resources

About