There have been no randomized trials examining the effect of hydrocortisone given after the first week of life or used to treat infants with prolonged ventilator dependence. One retrospective cohort study compared infants who required assisted ventilation and oxygen after the first one to two weeks of age and received hydrocortisone with a group of healthier infants who did not receive hydrocortisone.  Infants treated with hydrocortisone experienced decreasing oxygen requirements and were successfully weaned from assisted ventilation. After seven days of treatment, there were no differences in oxygen requirements between the two groups. On follow-up, there were no differences in head circumference, neurological outcome, psychomotor development or school performance. Magnetic resonance imaging performed at eight years of age on a similar cohort of infants treated with hydrocortisone showed that although, overall, children born preterm had significantly reduced grey matter volumes compared to term children, there were no differences in the intracranial volumes, grey matter volumes or white matter volumes between children who did and did not receive hydrocortisone for treatment of CLD.  There were also no differences in neurocognitive outcomes, assessed using the Wechsler Intelligence Scales for Children.
Unfamiliarity with these newer inhalers has been the source of some recently reported errors. A patient discharged from the hospital on Spiriva HandiHaler was readmitted 3 days later after taking 3 Spiriva capsules by mouth each day. He was unaware that the capsule was to be placed in the device so its contents could be inhaled. A color-blind patient was unable to tell if the indicator window on a Tudorza Pressair inhaler was red or green. The window turns green when the inhaler is loaded with a dose and ready to use, and red when the dose has been completely inhaled. Errors have happened to healthcare providers, too. In the pharmacy, an order for Incruse Ellipta was mistaken as “Increase Ellipta,” and the pharmacist dispensed Breo Ellipta, the only “Ellipta” inhaler with which he was familiar.
In a 2-year double-blind study in 103 male and female asthma patients 18 to 50 years of age previously maintained on bronchodilator therapy (Baseline FEV 1 85%-88% predicted), treatment with mometasone furoate dry powder inhaler 200 mcg twice daily resulted in significant reductions in lumbar spine (LS) BMD at the end of the treatment period compared to placebo. The mean change from Baseline to Endpoint in the lumbar spine BMD was - (-%) for the mometasone furoate dry powder inhaler group compared to (%) for the placebo group. In another 2-year double-blind study in 87 male and female asthma patients 18 to 50 years of age previously maintained on bronchodilator therapy (Baseline FEV 1 82%-83% predicted), treatment with mometasone furoate dry powder inhaler 400 mcg twice daily demonstrated no statistically significant changes in lumbar spine BMD at the end of the treatment period compared to placebo. The mean change from Baseline to Endpoint in the lumbar spine BMD was - (-%) for the mometasone furoate group compared to - (-%) for the placebo group.