Cochrane Summaries

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Use of oral steroids for cystic fibrosis

Cheng K, Ashby D, Smyth RL
Published Online: 
24 June 2013

Cystic fibrosis causes frequent lung infection and the airways become blocked with mucus. This in turn leads to inflammation, which causes more lung damage and more mucus to be produced. Corticosteroids are strong drugs given to treat this inflammation. The review includes three trials; one for 12 weeks and two with four-year follow up. We could not combine any data. Trials showed that oral steroids of 1mg/kg to 2 mg/kg (prednisolone equivalent) given every other day seemed to slow the advance of lung disease. However, there are serious adverse effects such as cataracts and the slowing of growth at the higher dose. These led to one trial stopping early. Follow-up data show that catch-up growth started two years after treatment ceased. Treatment must use the lowest effective dose and the shortest duration of therapy to reduce the risk of a permanent effect on growth. A dose of 1 mg/kg on alternate days might be considered for up to 24 months, but close attention should be paid to adverse effects. We do not expect any further trials of this treatment to be undertaken, so we do not plan to continue to regularly update the review. However, if any new information is published, we will include this when it is available.