Featured Research

from universities, journals, and other organizations

Steroids may help reduce deaths from all types of tuberculosis

March 12, 2013
University of St George's London
The routine use of steroids to treat tuberculosis may help reduce deaths from all types of the disease, according to a new review of existing research.

The routine use of steroids to treat tuberculosis may help reduce deaths from all types of the disease, according to a new review of existing research.

Each year there are 8.7million cases of TB worldwide, and it causes 1.4million deaths. The most common form of the disease (pulmonary TB) affects the lungs, but there are many other forms and it can affect almost all the body's organs.

Currently, steroids are routinely used only for certain types of TB -- each of which affects a different organ system -- where they have been proven effective as a secondary treatment alongside anti-TB drugs. Exactly how steroids help combat TB is not known, but they are believed to counter the tissue-damaging effect of the inflammatory response caused by the disease.

This latest research -- which summarised the findings of existing studies from 1955 to 2012 on the effect of steroids on all types of TB -- found that there were 17 per cent less deaths overall among patients taking steroids than those who were not. The study did not demonstrate a difference in death rates between different forms of TB.

The researchers say their findings suggest that steroids could work in a systemic way that is similar for all forms of the disease. Nevertheless, they say further studies are required before steroids should be recommended for all TB patients. Such studies should investigate if the reduced death rate is seen when looking at current TB drugs only, in studies with greater numbers of patients, and if the benefits of routinely prescribing steroids for all TB would outweigh the risk of harmful side effects. Potential side effects of steroid use include increased vulnerability to other infections.

The research was carried out by a team at St George's, University of London, in partnership with Newcastle University, the University of Liverpool and the Liverpool School of Tropical Medicine. It has been published in The Lancet Infectious Diseases.

The researchers analysed results from 41 previous major TB trials on the efficacy of corticosteroids -- drugs based on hormones found in the adrenal gland, which are used to reduce inflammation. They looked at trials involving the five common forms of TB for which steroid trials had been conducted. The types of TB were pericarditis (affecting the heart), meningitis (the brain and spinal cord), peritonitis (the abdomen) and pleurisy (the membranes surrounding the lungs). In total, they examined information on 3,560 patients who took steroids and 2,982 who did not. The types of steroids, the doses and the duration of treatment varied.

As the trials took place over 57 years, the anti-TB combination drug regimens also varied. Rifampicin -- the most effective and now most widely used anti-TB drug -- was not involved in any of the 19 trials held before 1983. All but one of the trials involving pulmonary TB were held pre-rifampicin. However, the researchers did not observe any difference in death rates of patients taking steroids between current and older treatments.

Lead author Professor Julia Critchley from St George's, University of London said: "There has been debate among clinicians on whether steroids should be routinely prescribed for TB patients. At the moment they're used in a specific way to target certain organ systems, and they have been proven effective in treating the meningitis and pericarditis forms of TB, but our findings suggest that the effects in one organ system might well apply to the others in terms of an overall reduction in deaths from the disease. There could therefore be benefit in using steroids for all tuberculosis."

But Professor Critchley added: "The quality and amount of evidence we had for each type of TB varied, and most of the trials took place before the emergence of drugs resistant to anti-TB therapies, so we need to do further studies to build up a more comprehensive and up-to-date picture."

Fiona Young, a research associate in public health from Newcastle University who contributed to the study, said: "The efficacy of steroid treatment for all forms of tuberculosis suggests there is an effect on death for TB of all types, although numbers were small.

"Tuberculosis presents a major public health challenge and it's important that we determine the effects of steroids in an era where drug resistance and HIV impact upon tuberculosis treatment outcomes."

Story Source:

The above story is based on materials provided by University of St George's London. Note: Materials may be edited for content and length.

Journal Reference:

  1. Julia A Critchley, Fiona Young, Lois Orton, Paul Garner. Corticosteroids for prevention of mortality in people with tuberculosis: a systematic review and meta-analysis. The Lancet Infectious Diseases, 2013; 13 (3): 223 DOI: 10.1016/S1473-3099(12)70321-3

Cite This Page:

University of St George's London. "Steroids may help reduce deaths from all types of tuberculosis." ScienceDaily. ScienceDaily, 12 March 2013. <www.sciencedaily.com/releases/2013/03/130312092438.htm>.
University of St George's London. (2013, March 12). Steroids may help reduce deaths from all types of tuberculosis. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2013/03/130312092438.htm
University of St George's London. "Steroids may help reduce deaths from all types of tuberculosis." ScienceDaily. www.sciencedaily.com/releases/2013/03/130312092438.htm (accessed July 31, 2014).

Share This

More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations

Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.


Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News


      Free Subscriptions

      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile

      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?

      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins