The response to inhaled and oral steroids in patients with stable chronic obstructive pulmonary disease

Weiner, P; Weiner, Margalit; Rabner, Marinella; Waizman, J; Magadle, Rasmi; Zamir, Doron

doi:10.1046/j.1365-2796.1999.00412.x

Cited by 27 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 It has been suggested that inhaled corticosteroids are more likely to have beneficial effects in patients with COPD when features of asthma are present. 10 It has recently been reported that prednisolone has a beneficial effect in patients with COPD who have increased numbers of sputum eosinophils.…”

mentioning

confidence: 99%

Effects of fluticasone propionate in COPD patients with bronchial hyperresponsiveness

Verhoeven

Hegmans²,

Mulder³

et al. 2002

Thorax

View full text Add to dashboard Cite

Background: Treatment of chronic obstructive pulmonary disease (COPD) with inhaled corticosteroids does not appear to be as effective as similar treatment of asthma. It seems that only certain subgroups of patients with COPD benefit from steroid treatment. A study was undertaken to examine whether inhaled fluticasone propionate (FP) had an effect on lung function and on indices of inflammation in a subgroup of COPD patients with bronchial hyperresponsiveness (BHR). Methods: Twenty three patients with COPD were studied. Patients had to be persistent current smokers between 40 and 70 years of age. Non-specific BHR was defined as a PC 20 for histamine of <8 mg/ ml. Patients received either 2 × 500 µg FP or placebo for 6 months. Expiratory volumes were measured at monthly visits, BHR was determined at the start of the study and after 3 and 6 months, and bronchial biopsy specimens were taken at the start and after 6 months of treatment. Biopsy specimens from asymptomatic smokers served as controls. Results: In contrast to asthma, indices of BHR were not significantly influenced by treatment with FP. Forced expiratory volume in 1 second (FEV 1 ) showed a steep decline in the placebo group but remained stable in patients treated with FP. FEV 1 /FVC, and maximal expiratory flows at 50% and 25% FVC (MEF 50 , MEF 25 ) were significantly increased in the FP treated patients compared with the placebo group. Biopsy specimens were analysed for the presence of CD3+, CD4+, CD8+, MBP+, CD15+, CD68+, CD1a, and tryptase cells. FP treatment resulted in marginal reductions in these indices of inflammation. Conclusion: In patients with COPD and BHR, FP has a positive effect on indices of lung function compared with placebo. Bronchial inflammation analysed in bronchial biopsy specimens is only marginally reduced.

show abstract

mentioning

confidence: 99%

Effects of fluticasone propionate in COPD patients with bronchial hyperresponsiveness

Verhoeven

Hegmans²,

Mulder³

et al. 2002

Thorax

View full text Add to dashboard Cite

show abstract

“…However, ICS are recommended for regular treatment in COPD patients with more severe disease and frequent exacerbations [25,26]. Some studies showed clinical benefits with ICS use in moderate to severe but not in mild COPD [33][34][35][36]. ICS use is associated with reductions in the number and severity of exacerbations experienced by patients with severe COPD [34,[36][37][38][39].…”

Section: Treatment Options For Copdmentioning

confidence: 99%

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Schayck

Reid

2006

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Summary Chronic obstructive pulmonary disease (COPD) is the internationally preferred term for chronic, progressive lung disorders which are characterised by airflow limitation that is not fully reversible. The symptoms of COPD -including breathlessness, cough, excessive sputum production and reduced muscle tone and muscle wasting -reflect the complex pathophysiology of the disease. In order to address these symptoms, treatment regimens should take into account the multiple components that contribute to COPD. Clinical evidence has emerged indicating that, especially in patients with severe COPD, long-acting beta 2 -agonists (LABAs) and inhaled corticosteroids (ICS) result in improvements in symptoms, reduce the frequency and severity of exacerbations, and improve health-related quality of life. This review evaluates the clinical evidence for the potential of LABA/ICS treatment to address the symptoms of COPD and whether combination therapy of this nature adds significant benefit to patients.

show abstract

“…Thus, it seems most likely that use of digoxin might have provoked increases in the blood glucose levels with a growing need for antidiabetic drugs. Thrombomodulin and acute bleeding duodenal ulcer DEAR SIR, Bleeding is the most common serious complication of peptic ulcer disease, with a mortality rate still about 5% [1]. Recently, a study has documented that an increased concentration of soluble thrombomodulin (sTM) in plasma predicts the incidence of serious bleeding complications in patients on oral warfarin therapy [2].…”

Section: ++mentioning

confidence: 99%

“…We have read with interest the study by Weiner and colleagues [1] presenting the result that doses of up to 800 mg budesonide bid may be safe and very effective. In general, local application of steroids is a first-line strategy in chronic obstructive pulmonary disorder (COPD).…”

Section: ++mentioning

confidence: 99%

“…In rabbits, digoxin has been shown to increase the blood glucose concentrations and to reduce the hypoglycemia induced by insulin [1]. The author concludes that digoxin can cause unpredictable alterations in the blood glucose concentrations of diabetic patients and recommends that blood glucose levels should be carefully monitored whenever digoxin is prescribed to diabetic patients [1].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Increased glucose intolerance related to digoxin treatment in patients with type 2 diabetes mellitus

Spigset

Mjörndal²

1999

Journal of Internal Medicine

View full text Add to dashboard Cite

The response to inhaled and oral steroids in patients with stable chronic obstructive pulmonary disease

Cited by 27 publications

References 16 publications

Effects of fluticasone propionate in COPD patients with bronchial hyperresponsiveness

Effects of fluticasone propionate in COPD patients with bronchial hyperresponsiveness

Effective management of COPD in primary care — the role of long-acting beta agonist/inhaled corticosteroid combination therapy

Increased glucose intolerance related to digoxin treatment in patients with type 2 diabetes mellitus

Contact Info

Product

Resources

About