Steroids May Help Reduce Deaths from all Types of Tuberculosis
A team led by researchers from St. George’s, University of London, reviewed results of 41 TB studies conducted between 1955 and 2012 and found there were 17 percent less deaths among patients taking anti-TB drugs and corticosteroids (steroids) in comparison to patients taking only anti-TB drugs.
While most TB cases are the pulmonary form of TB, other forms of TB can attack almost any organ. The review included pulmonary, pericarditis, meningitis, peritonitis, and pleurisy TB studies. The team analyzed data from 41 major TB trials on the efficacy of corticosteroids, which are based on adrenal gland hormones, in combination with anti-TB drugs. The study included 3,560 patients who had received both TB drugs and steroids, and 2,982 who had received only TB drugs. The participants’ treatment regimens varied in dosage and duration.
Prof. Julia A Critchley, DPhil, reports that, regardless of the TB form, adding steroids to anti-TB drugs lowered the risk of death for all patients. Until now, steroids have only been proved effective as a secondary treatment for meningitis and pericarditis forms of TB. Critchley cautioned that before recommending steroids for all TB patients, further studies should address the benefits of steroids in combination with current TB drugs and consider whether the benefits of steroids outweigh harmful side effects. The most effective current anti-TB drug, Rifampicin, was not available during the 19 trials conducted prior to 1983. Taking steroids makes patients more vulnerable to other infections.
Research associate Fiona Young stated that the presence of drug-resistant forms of TB and the effects of HIV on TB treatment underscore the importance of understanding the benefits of steroid treatment.
The full report, “Corticosteroids for Prevention of Mortality in People with Tuberculosis: A Systematic Review and Meta-analysis,” was published online in the journal The Lancet Infectious Diseases (2013; doi:10.1016/S1473-3099(12)70321-3.
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