Effective treatment of steroids: A Synthesis of Findings from 6 Studies

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Original Abstract of the Article

Key Research Findings

A study on the effectiveness of methotrexate in treating Crohn's disease showed that methotrexate was more effective than placebo in improving symptoms and reducing the need for prednisone in patients with chronically active Crohn's disease. 1

A study on the benefits of inhaled corticosteroids in the emergency department treatment of acute asthma showed that inhaled corticosteroids reduced hospital admission rates in patients with acute asthma who were not receiving concomitant systemic steroids. In children, inhaled corticosteroids appeared to be at least as effective as systemic steroids. 2

Research on the efficacy of immunosuppressive and cytotoxic therapies for pulmonary sarcoidosis found that the current evidence supporting the use of immunosuppressive and cytotoxic therapies is limited. Side effects associated with some of these therapies were severe. 3 4

A study examining a patient education program to enhance decision autonomy in multiple sclerosis relapse management found that despite strong recommendations for high-dose intravenous corticosteroid treatment for relapses, uncertainty remains about most aspects of relapse management. Oral corticosteroids administered by physicians or patients themselves or no corticosteroids also appear justifiable. 5

Research on the role of steroids in the management of brain metastases concluded that steroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. Dexamethasone is the recommended steroid choice. 6

Treatment Summary

Methotrexate was found to be an effective treatment for Crohn's disease, specifically for patients experiencing chronically active Crohn's disease. 1

Inhaled corticosteroids showed efficacy in treating acute asthma, particularly for patients not receiving concomitant systemic steroids. They were found to reduce hospital admission rates in these individuals. 2

Immunosuppressive and cytotoxic therapies for pulmonary sarcoidosis, including methotrexate, chloroquine, cyclosporine A, and pentoxifylline, are used for this condition. However, the evidence supporting their efficacy is limited, and some therapies have been associated with severe side effects. 3 4

High-dose intravenous corticosteroid treatment is recommended for multiple sclerosis relapses. Nevertheless, there is uncertainty surrounding other aspects of relapse management. Oral corticosteroids administered by physicians or patients or no corticosteroids at all may also be valid options. 5

Steroids are recommended for temporary relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. Dexamethasone is the preferred steroid choice in such instances. 6

Benefits and Risks

Benefit Summary

Methotrexate has been shown to improve symptoms and reduce the need for prednisone in patients with chronically active Crohn's disease. 1

Inhaled corticosteroids have been shown to reduce hospital admission rates in patients with acute asthma who are not receiving concomitant systemic steroids. 2

Steroids are recommended to provide temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. 6

Risk Summary

Methotrexate has been associated with side effects such as asymptomatic elevation of serum aminotransferase and nausea. 1

Immunosuppressive and cytotoxic therapies can have severe side effects. 3 4

Long-term use of steroids comes with various risks. 6

Comparison between Studies

Commonalities in Studies

All studies aimed to evaluate the efficacy and safety of treatments for specific diseases or symptoms.

Differences between Studies

Studies varied in terms of the diseases being studied, the treatments used, the study designs, and the outcomes assessed.

Consistency and Inconsistencies in Findings

These studies provide evidence regarding the efficacy of specific treatments for certain diseases or symptoms. However, not all studies arrive at the same conclusions. For instance, research on the efficacy of immunosuppressive and cytotoxic therapies for pulmonary sarcoidosis found limited evidence supporting their effectiveness, and some therapies were associated with serious side effects. 3 4

Real-World Application Considerations

The findings of these studies offer valuable information to consider when choosing treatments for specific diseases or symptoms. However, it is important to remember that these results may not apply to all individuals. Consulting with a physician and determining the best course of treatment based on individual circumstances is essential.

Limitations of Current Research

Many of these studies were relatively small, and further research is warranted.

Directions for Future Research

Further research is needed to evaluate the efficacy and safety of treatments for these diseases and symptoms in more detail.

Conclusion

These studies provide valuable information regarding the effectiveness of specific treatments for specific diseases and symptoms. However, not all studies reach the same conclusions. When making treatment decisions, it is crucial to consult with a physician and make the best choice based on individual circumstances.

Treatment List

Methotrexate, Inhaled Corticosteroids, Prednisone reduction, Dexamethasone, Chloroquine, Cyclosporine A, Pentoxifylline

Literature analysis of 6 papers
Positive Content
4
Neutral Content
2
Negative Content
0
Article Type
2
0
4
4
6
1.

Methotrexate for the treatment of Crohn's disease. The North American Crohn's Study Group Investigators.

Author: FeaganB G, RochonJ, FedorakR N, IrvineE J, WildG, SutherlandL, SteinhartA H, GreenbergG R, GilliesR, HopkinsM

Crohn's disease treatment
Prednisone reduction
Methotrexate side effects

Methotrexate was more effective than placebo in improving symptoms and reducing requirements for prednisone in patients with chronically active Crohn's disease.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Early use of inhaled corticosteroids in the emergency department treatment of acute asthma.

Author: EdmondsM L, CamargoC A, PollackC V, RoweB H

Improved lung function
Reduced hospital admissions
Limited evidence

Inhaled steroids reduced admission rates in patients with acute asthma who were not receiving concomitant systemic steroids. In children, inhaled steroids appear to be at least as effective as systemic steroids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Author: ParamothayanS, LassersonT, WaltersE H

Steroid sparing effect
Severe side effects

The current body of evidence supporting the use of immunosuppressive agents and cytotoxic therapies in pulmonary sarcoidosis is limited, with severe side-effects associated with some therapies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Author: ParamothayanS, LassersonT J, WaltersE H

Steroid sparing effect
Severe side effects

There is limited evidence to support the use of immunosuppressive agents and cytotoxic therapies for pulmonary sarcoidosis. Side effects associated with some of these therapies were severe.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Patient education program to enhance decision autonomy in multiple sclerosis relapse management: a randomized-controlled trial.

Author: KöpkeS, KasperJ, MühlhauserI, NüblingM, HeesenC

Improved MS relapse

Uncertainty remains about most aspects of relapse management in multiple sclerosis (MS), including the optimal dose and timing of corticosteroid treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline.

Author: RykenTimothy C, McDermottMichael, RobinsonPaula D, AmmiratiMario, AndrewsDavid W, AsherAnthony L, BurriStuart H, CobbsCharles S, GasparLaurie E, KondziolkaDouglas, LinskeyMark E, LoefflerJay S, MehtaMinesh P, MikkelsenTom, OlsonJeffrey J, PaleologosNina A, PatchellRoy A, KalkanisSteven N

Brain metastases symptom relief
Increased intracranial pressure reduction
Corticosteroid long-term sequelae

Corticosteroids are recommended for temporary symptomatic relief of symptoms related to increased intracranial pressure and edema secondary to brain metastases. Dexamethasone is the preferred steroid, and doses should be tailored to symptom severity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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