Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new rhinocort research articles will be listed here shortly after becoming available to us.
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Medical research on rhinocort
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jul; 106(1): e11-7
Utsman RA, Epstein JB, Elad S
Local immunosuppressive therapies without systemic effects represent a therapeutic advantage in management of immune/inflammatory oral mucosal conditions. Topical budesonide rinses were prescribed to patients with mucosal disease that was resistant to other intervention without side effects. A case of paraneoplastic pemphigus and a patient with oral graft-versus-host disease that had not responded to standard approaches to management were successfully managed with budesonide rinse application. The cases presented represent mucosal conditions that were successfully managed with topical application of budesonide with reduced risk of systemic effects.
Otolaryngol Head Neck Surg. 2008 Jul; 139(1): 131-6
Kanowitz SJ, Batra PS, Citardi MJ
BACKGROUND: Nebulized budesonide (Pulmicort Respules, AstraZeneca, Wilmington, DE) provides control of respiratory tract inflammation in asthmatic patients. The Mucosal Atomization Device (MAD; Wolfe-Tory Medical, Salt Lake City, UT) is a novel sinonasal atomization device. METHODS: Uncontrolled case series of postoperative patients with chronic rhinosinusitis (CRS) who received budesonide via MAD was performed. RESULTS: A total of 44 patients with a mean age of 53.5 years met inclusion criteria. The average follow-up was 31.5 weeks (SD 17.55; range, 8 to 80 weeks). Overall, patient and physician global assessments demonstrated moderate to significant improvement. Average daily oral prednisone usage among patients who took systemic steroids (n = 27) was reduced from 7.96 to 1.94 mg/day without relapse of polyps, mucosal edema, and nasal discharge. Prednisone use was reduced to zero in 16 patients and reduced or stabilized in 10 other patients. CONCLUSION: Topical budesonide via MAD may reduce the need for systemic prednisone and improve both physician and patient global assessment scores in postoperative CRS patients. Additional investigation is warranted to exclude placebo effect, spontaneous resolution, and regression to the mean as responsible factors for the reported findings.
Pediatr Emerg Care. 2008 Jun 17;
Borland ML, Babl FE, Sheriff N, Esson AD
OBJECTIVE:: Comparison of clinical practice guideline (CPG) recommendations and reported physician management of croup at PREDICT (Paediatric Research in Emergency Departments International Collaborative) sites as baseline for planned randomized controlled trials. METHODS:: Review of CPGs for croup from PREDICT sites and survey of specialist pediatric emergency physicians regarding croup management. PREDICT sites included 8 tertiary pediatric hospitals and 3 large mixed emergency departments in Australia and New Zealand. RESULTS:: Nine of the 11 sites had a CPG for croup. Response rate was 94% (78/83). Adrenaline was recommended for moderate croup (3%), severe croup (52%), and life-threatening croup by (100%). Steroid therapy was recommended for mild croup (45%), for moderate croup (97%), for severe croup (97%), and for life-threatening croup (96%). Steroid choice was oral dexamethasone (60%) and oral prednisolone (38%). In severe croup, 77% used intravenous/intramuscular dexamethasone, 10% used intravenous/intramuscular methylprednis olone, and 8% used nebulized budesonide. Commonest dosage regimens were 0.15 mg/kg dexamethasone or 1 mg/kg prednisolone. A standard volume dosage regimen for nebulized adrenaline was used by 54%, whereas 39% used a weight-based formula. Clinical practice guidelines recommended 5 mg (11%) or 10 mg (33%) for standard volume dosing, and all CPGs using weight-based dosing recommend 0.5 mg/kg with maximum doses ranging from 5 to 15 mg. CONCLUSIONS:: Croup management at PREDICT emergency departments is similar, based on oral steroids and nebulized adrenaline. The steroid and adrenaline regimens used by respondents and their CPGs were not consistent. This reflects limitations of available evidence for management of this common disease, highlighting the need for definitive trials, particularly in the management of mild croup.
Int Arch Allergy Immunol. 2008; 146 Suppl 1: 22-7
Soma T, Takaku Y, Kobayashi T, Hagiwara K, Kanazawa M, Uematsu K, Nagata M
BACKGROUND: The use of a budesonide (BUD)/formoterol (FOR) combination (Symbicort) for both maintenance and reliever therapy reduces the exacerbation of asthma better than the traditional fixed-dose regimens. In the early stage of exacerbation, the combination therapy could intervene with the development of subsequent airway inflammation. The objective of the study was to evaluate whether in the early stage of cell activation the use of BUD/FOR combination would modify the adhesion of eosinophils or production of cytokines from mononuclear cells. METHODS: Human peripheral blood eosinophils, pretreated with BUD (0.1 microM), FOR (0.1 microM) or BUD/FOR combination for 30 min at 37 degrees C, were stimulated with IL-5, leukotriene D4 or phorbol myristate acetate, and eosinophil adhesion was evaluated using an eosinophil peroxidase assay. BUD (0.1 microM), FOR (0.1 microM) or BUD/FOR combination was added to the peripheral blood mononuclear cells stimulated with ionomycin plus phorbol myristate acetate. Concentrations of IL-5 and RANTES in the cell supernatant were measured using ELISA. RESULTS: BUD, FOR or BUD/FOR combination did not modify the eosinophil adhesion induced by any stimulators. In contrast, BUD or BUD/FOR combination significantly reduced the productions of IL-5 and RANTES in peripheral blood mononuclear cells (BUD: p < 0.0001, p = 0.027 vs. control; BUD/FOR: p < 0.0001, p = 0.031 vs. control) when the drugs were added 15 min, but not 4 h, following cell stimulation. CONCLUSION: In the early stage of exacerbation of asthma, inhaled BUD may suppress the progression of the allergic inflammatory cascade by inhibiting the mononuclear cells. These results also underline the importance of using BUD in rescue inhaler.
Mortality in COPD: inevitable or preventable? Insights from the cardiovascular arena.
COPD. 2008 Jun; 5(3): 187-200
Halpin D
Mortality due to chronic obstructive pulmonary disease continues to rise, whereas mortality rates related to cardiovascular disease appear to be slowing, or even declining. This is due at least in part to more widespread use of preventative therapies that have been shown to reduce cardiovascular mortality, raising the question of whether appropriate use of therapies for chronic obstructive pulmonary disease which potentially reduce mortality could have a similar impact. This article discusses approaches used successfully in managing heart disease and considers whether these can be applied to chronic obstructive pulmonary disease and whether a better understanding of the strongest predictors of mortality in chronic obstructive pulmonary disease is needed. It reviews the role of inhaled corticosteroids, both alone and in combination with long-acting beta(2)-agonists, in individuals with chronic obstructive pulmonary disease, including the role of combination therapy with inhaled corticosteroids/long-acting beta(2)-agonists (budesonide/formoterol or salmeterol/fluticasone propionate) in decreasing exacerbations and improving health status, potentially providing survival benefits in chronic obstructive pulmonary disease. This review also discusses the potential impact of treatments indicated for cardiovascular disease on chronic obstructive pulmonary disease and possible links between the two diseases.
Beta2-agonists potentiate corticosteroid-induced neutrophil survival.
COPD. 2008 Jun; 5(3): 163-9
Perttunen H, Moilanen E, Zhang X, Barnes PJ, Kankaanranta H
Neutrophils are considered to play a role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and severe asthma. Recent guidelines recommend the use of a combination of inhaled corticosteroids (ICS) and long-acting beta2-agonists (LABA) in the treatment of COPD with exacerbations and asthma not adequately controlled by ICS alone. LABA have been proposed to have a synergistic effect with corticosteroids by activating glucocorticoid receptors. The aim of this study was to investigate the effect of beta2-agonists on the inhibitory effects of corticosteroids on human neutrophil apoptosis. In addition, the effects of beta2-agonists on spontaneous neutrophil apoptosis and on GM-CSF- and LTB4-afforded survival were also evaluated. Neutrophils were isolated from human blood under sterile conditions and cultured for 16 hours. Apoptosis was assessed by relative DNA fragmentation assay. Morphological analysis was used as a control method to confirm the occurrence of apoptosis. Salbutamol, formoterol and salmeterol prolonged the lifespan of budesonide- and fluticasone propionate-treated neutrophils by inhibiting apoptosis. Formoterol and salbutamol partly reversed the inhibitory effect of GM-CSF on neutrophil apoptosis. In contrast, the effects of beta(2)-agonists on spontaneous neutrophil apoptosis and on LTB(4)-afforded survival were negligible. beta2-agonists potentiate corticosteroid-induced neutrophil survival at clinically relevant drug concentrations. Whether these effects translate into clinically relevant changes in lung neutrophil numbers remains to be demonstrated.
[Adrenal insufficiency during inhaled corticosteroid treatment in a child with asthma]
Ugeskr Laeger. 2008 Jun 9; 170(24): 2161
Bjerre JV, Bender L, Naeraa RW, Rix M
We report a 12 year-old asthmatic girl with adrenal insufficiency during inhaled corticosteroid treatment. Symptoms, investigations and treatment are discussed.
Arch Dermatol. 2008 Jun; 144(6): 749-55
Warshaw EM, Furda LM, Maibach HI, Rietschel RL, Fowler JF, Belsito DV, Zug KA, DeLeo VA, Marks JG, Mathias CG, Pratt MD, Sasseville D, Storrs FJ, Taylor JS
OBJECTIVES: To characterize patients with anogenital dermatitis referred for patch testing by the North American Contact Dermatitis Group, to identify common allergens, and to explore sex associations. DESIGN: Retrospective, cross-sectional analysis of the North American Contact Dermatitis Group database, 1994-2004. PATIENTS: Five hundred seventy-five patients with anogenital signs or symptoms were referred for patch testing; 347 had anogenital disease only. MAIN OUTCOME MEASURE: Currently relevant allergic patch test reaction in patients with anogenital signs or symptoms. RESULTS: Sex percentages and mean age were not significantly different in patients with anogenital involvement only compared with those without anogenital involvement. In patients with anogenital involvement only, a final diagnosis of "other dermatoses" was statistically significantly more common in female patients compared with male patients (n = 347; relative risk, 1.99; 95% confidence interval, 1.37-2.91), but the diagnosis of allergic contact dermatitis was not associated with sex. Specific allergens that were statistically significantly more common in patients with anogenital involvement included cinnamal (or cinnamic aldehyde), dibucaine, benzocaine, hydrocortisone-17-butyrate, and budesonide (all P < .005). Those that were statistically significantly less frequent included quaternium-15, cobalt chloride, formaldehyde, p-phenylenediamine, and thiuram mix (all P < .04). Seventy-three patients had anogenital allergic contact dermatitis, defined as anogenital involvement only, allergic contact dermatitis as the only diagnosis, and at least 1 positive reaction of current clinical relevance. In that subgroup, the most common allergen sources were cosmetics, medications, and corticosteroids. CONCLUSION: In patients in the North American Contact Dermatitis Group with anogenital involvement only, male and female patients were equally likely to have allergic contact dermatitis but female patients were more likely to have other dermatoses. Common allergens and sources consisted of those likely to have contact with the anogenital area.
[Microscopic colitis: collagenous colitis and lymphocytic colitis]
Ann Pathol. 2007 Dec; 27(6): 448-58
Chatelain D, Mokrani N, Fléjou JF
Microscopic colitis is currently classified as a chronic inflammatory bowel disorder and encompasses two entities: lymphocytic colitis and collagenous colitis. Patients with microscopic colitis present with a well-tolerated chronic watery diarrhea, sometimes with abdominal pain. Colonoscopy is normal. Diagnosis of microscopic colitis is established by histologic examination of colonic biopsies, showing a thickened subsurface collagen band higher than 10 microm in collagenous colitis, and an increased number of surface intra-epithelial lymphocytes higher than 20 lymphocytes per 100 epithelial cells in lymphocytic colitis. Causes of microscopic colitis are still unknown, although a drug-induced etiology is found in some cases. Patients are usually treated with budesonide but recurrences are frequent.
[Effect of budesonide on the heme oxygenase-1 expression in lung tissues of rats with asthma.]
Zhongguo Dang Dai Er Ke Za Zhi. 2008 Jun; 10(3): 376-80
Xu X, Zhong LL, Jiao SM, Liu SS, Li Y, Zhang B
OBJECTIVE: To study the expression of heme oxygenase-1 (HO-1) gene and protein and the effect of budesonide (BUD) on the HO-1 expression in lung tissues in rats with asthma. METHODS: Fifty male Sprague-Dawley rats were randomly divided into 5 groups: normal control, asthma model, dexamethasone (DXM)-, hemin (HO-1 challenger)-or BUD-treated asthma. The asthma model was prepared by ovalbumin sensitization and challenge. The rats were sacrificed 24 hrs after the last challenge. The blood COHb content,and the total cell count and the percentage of differential cells in bronchoalveolar lavage fluid (BALF) were measured. The expression of HO-1 protein and mRNA in lung tissues was detected with immunohistochemistry and RT-PCR, respectively. The airway inflammation situations were evaluated by histopathology. RESULTS: The airway inflammatory cell infiltration in the DXM-, hemin- and BUD-treated asthma groups was remarkably alleviated compared with that in the asthma model group. Compared with the normal control group, the expression of HO-1 mRNA and protein in lung tissues and the blood COHb content in the asthma model and the DXM-, hemin- and BUD-treated asthma groups were significantly up-regulated. The DXM-, hemin- and BUD-treated asthma groups showed significantly increased expression of HO-1 protein and mRNA in lung tissues compared with the asthma model group. The blood COHb content in the DXM-and the hemin-treated asthma groups was significantly higher than that in the asthma model group. CONCLUSIONS: The expression of HO-1 protein and mRNA in lung tissues and blood HO-1 activity increased in rats with asthma,suggesting that HO-1 may be involved in the pathogenesis of asthma. HO-1 may have a protective effect against the airway inflammation in asthmatic rats. BUD and DXM can up-regulate the expression of HO-1 protein and mRNA, thus providing protective effects against the airway inflammation in asthmatic rats.