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Monday, 30 January 2017

Steroid Inhalers. Not as good as we were told, and more harmful to our health

Many people use inhalers, and have done for decades. Now it has been discovered they are not as good as we have been told, and they are more harmful to our health too. New NICE guidelines have been issued, asking doctors to start reviewing all COPD patients, and consider taking those using inhaled steroids off their inhalers. It is thought that this could involve at least 500,000 patients.

               "It comes amid mounting evidence that steroids are less effective in COPD than previously thought and also more harmful – in particular by increasing the risk of pneumonia, as well as other side-effects such as worsening diabetes and reduced bone density."

The GP's magazine in Britain, Pulse, from which this quote is taken, say that new international guidelines are advising greater caution with the use of steroid inhalers following publication of "a raft of new studies". Experts in respiratory medicine are calling for an overhaul of the management of patients with COPD in primary care.

Yet this is a process to which the conventional medical establishment has subjected us too now for a very long time.
  • New treatments are introduced, heralded as wonder cures for this or that ailment, with its benefits greatly exaggerated, and its side effects greatly underestimated.
  • Millions of people are placed on the treatment in the belief that it is helpful, and that they are safe taking it.
  • The Pharmaceutical Industry makes enormous profits.
  • Decades later 'medical science' discovers that it got it wrong, the treatment is not a wonder cure, and the harm it does was far greater than they had previously thought.
  • There is a grudging, but partial recognition that patients have  been, and are being harmed, that the health of many may have been compromised.
Doctors are already overworked. The NHS is already in crisis because of the demands made upon it by sick patients. Many more of these demands, it would seem, are the result of inhalers! One recent study (Price D, et al. First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis. NPJ Prim Care Respir Med 2016; online 3 Nov. has apparently showed more than half of patients with COPD were started on an ICS inhaler and, as many more will have therapy stepped up. Now most of them could probably be taken off steroid therapy completely. The medication they have been taking, sometimes for decades, are no longer considered to be safe!

So how many patients have suffered pneumonia, worsening diabetes, and reduced bone density because of the inhalers prescribed to them as effective and safe?

Pulse does not say. Perhaps no-one knows. Perhaps no-one want us to know! Yet Pulse states that a recent study highlighted that large numbers of patients, with mild or moderate COPD, end up on triple therapy - with two long-acting bronchodilators and an ICS. This, the new guidelines state, is treatment that should be reserved for those with the most severe disease.

Consider this for a moment, and then ask what sort of medical system it is that has dominating health care for the last 100 years!

  • Patients with mild or moderate COPD have been over-drugged with inhalers that are less effective and more harmful than previously realised, and as a result many patients have suffered from pneumonia, worsening diabetes, and reduced bone density as a direct result.
  • In future, it will only be the sickest patients who will have this level of treatment because it is no known that it has too many harmful side effects, it is just too dangerous for anyone else! In other words, the sickest are getting the most dangerous treatment!
No wonder the NHS is in crisis. As I have said many times before pharmaceutical drugs and vaccines are not making us better, they are the cause of increased levels of sickness and disease.

Yet there is a further problem for the conventional medical establishment. Their medicine cupboard has just become a little bit barer!

  • Antibiotics are failing, coming to the end of their useful life.
  • Painkillers have so many serious side effects they should only be used with the greatest caution
  • Psychiatric drugs are so dangerous to our health that doctors have to use 'talking therapies' instead.
Now doctors are losing their inhalers. So what do they have to replace them? The Pulse article provides us with the answer

               "One barrier to stepping down therapy is that it is often started because of a lack of alternatives. Dr Gruffydd-Jones adds: ‘Pulmonary rehabilitation has not been freely available in a timely manner. Waiting lists can be several months, so as a GP what are you going to do? You feel you have got to try something and end up escalating the treatment.’"

So this is yet another very serious problem for the conventional medical establishment. They have been prescribing dangerous and ineffective drugs for a long time. As a nation they have made us sicker. They are running out of money. They are running out of drugs. And they are running out of time!

References given in the Pulse article.

GOLD, 2017. Global Strategy for the Diagnosis, Management and Prevention of COPD.

NICE CG101. COPD in over-16s: diagnosis and management, 2010.

Price D et al. First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis. NPJ Prim Care Respir Med 2016; online 3 Nov.

Haughney J et al. The distribution of COPD in UK general practice using the new GOLD classification. Eur Respir J 2014;43:993–1002.

Royal College of Physicians, 2016. National COPD Audit Programme: primary care work stream.

White P et al. Overtreatment of COPD with inhaled corticosteroids. Implications for safety and costs: cross-sectional observational study. PLoS ONE 8: e75221.

Mak V and D’Ancona G. Avoiding inappropriate prescribing of high dose inhaled corticosteroid combination inhalers – is the message getting through? Thorax 2016;71 (Suppl 3):A118-A119.