Steroids Ease Respiratory Ailments

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News Article: Steroids Ease Respiratory Ailments

<SMALL><I>By LINDA A. JOHNSON, Associated Press Writer</I></SMALL>

Inhaled steroids widely used to treat emphysema and other

degenerative respiratory ailments do not slow the progression of

the disease but can ease the symptoms during flare-ups, a

government study found.

Steroids reduced urgent doctor's visits, hospitalizations and

airway sensitivity to cold and other irritants.

But long use caused two side effects: increased skin bruising

and loss of bone density.

The study looked at chronic obstructive pulmonary disease, which

includes chronic bronchitis and emphysema. It progressively reduces

how much air the lungs can hold and is considered largely

untreatable.

Doctors had hypothesized that inhaled steroids widely used for

asthma might slow progression of chronic obstructive pulmonary

disease by reducing airway inflammation. But the researchers found

no significant difference in lung function decline.

However, the patients who used steroids had about one-fourth

fewer flare-ups of breathing difficulty, just over half as many

doctor's visits and less airway sensitivity to irritants.

The study was published in Thursday's New England Journal of

Medicine.

About 560 patients with a moderate form of the disease took six

puffs of medicine from an inhaler twice a day for more than three

years. A comparison group inhaled a dummy solution.

Dr. A. Wise, a pulmonary disease specialist at s

Hopkins University who helped lead the study, said the findings

mean that inhaled steroids still have a role in treating patients

with frequent symptoms of the deadly lung disease. But he said they

should be given calcium and vitamin D supplements.

" This is really going to be an individual decision between the

patient and physician, " said Dr. Norman H. Edelman, dean of the

medical school at the State University of New York at Stony Brook

and a consultant to the American Lung Association.

About 16 million Americans have chronic obstructive pulmonary

disease, the nation's No. 4 cause of death and No. 2 cause of

disability.

Inhaled steroids " are commonly prescribed for patients with

COPD, although their effectiveness has not been consistently

shown, " said Dr. Claude Lenfant, director of the National Heart,

Lung and Blood Institute. The latest findings " provide us with the

full picture of their benefits and risks. "

The institute funded the study. The steroid tested, Azmacort,

was provided by manufacturer Aventis Pharma of Parsippany, N.J.

The patients used their medication only about 60 percent as

frequently as directed. That is actually better than the average

for members of the public with chronic health conditions.

" If there had been 100 percent compliance, maybe there would

have been an effect on progression of the disease, " Edelman said.

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On the Net:

New England Journal of Medicine: <A HREF=http://www.nejm.com>http://<A

HREF=http://www.nejm.com>www.nejm.com</A></A>

National Heart, Lung and Blood Institute site:<BR>

<A

HREF=http://www.nhlbi.nih.gov/index.htm>http://www.nhlbi.nih.gov/index.htm</

A>