Friday, August 31, 2007

Anti-inflammatory Agent: Corticosteroids

Prednisone is perhaps the most recognizable and most prescribed anti-inflammatory agent for cystic fibrosis patients. This corticosteroid has been proven effective in suppressing inflammation of the lungs. Studies have demonstrated that doses of 60mg are useful in lowering the IgE levels of patients who suffer from allergic bronchopulmonary aspergilliosis (ABPA.)

Despite its success in treating inflammation, many patients who have undergone corticosteroid therapy report unfavorable side effects. The most challenging side effect is the onset of steroid-induced diabetes. Blood glucose levels must be monitored frequently when a patient is being treated with prednisone. Rapid weight gain due to fluid buildup is also common. This can cause something called “moon face” which is when most of the weight makes the patient’s face appear quite puffy and round. Frequent usage of prednisone has been linked to osteoporosis, which is already a co-occurring condition in patients with CF.

A study conducted in 1999 suggested that ongoing treatment with prednisone may have adverse effects on a patient’s growth pattern. This was observed most in male patients who had not yet gone through puberty.

The benefits of corticosteroids are best observed when they are used to treat and control the effects of asthma. For example, oral soluble prednisolone (Prednisone), inhaled budesonide (Pulmicort Turbuhaler) or fluticasone proprionate (Flonase intranasal spray) are helpful particularly in young patients who are wheezy and have associated asthma.

In general, corticosteroids such as prednisone are prescribed when other attempts to reduce inflammation of the airways have failed.

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