Steroid• A steroid is a type of organic compound that contains a

characteristic arrangement of four cycloalkane rings that are joined to each other.

• Examples of steroids include the dietary fat cholesterol, the sex hormones estradiol and testosterone, and the anti-inflammatory drug dexamethasone.

Steroids

Animal

Steroid hormon

es

Sex Hormones e.g. androgens, estrogens, and progestagens

Corticosteroids

Glucocorticoids

Mineralocorticoids

Anabolic steroids

Cholesterol

Plant

Brassinosteroids

Phytosterols

Fungal

Ergosterols

Classification of Steroids

• Corticosteroids are a class of chemicals that includes steroid hormones naturally produced in the adrenal cortex of vertebrates and analogues of these hormones that are synthesized in laboratories.

Corticosteroids are mainly of 2 types1. Glucocorticoids

2. Mineralocorticoids

Corticosteroids

Glucocorticoids = glucose + cortex + steroid

• The name glucocorticoid derives from their role in the regulation of the metabolism of glucose, their synthesis in the adrenal cortex, and their steroidal structure.

• Glucocorticoids (GC) are a class of steroid hormones that bind to the glucocorticoid receptor (GR), which is present in almost every vertebrate animal cell.

Functions1. Control carbohydrate, fat and protein metabolism2. Anti-inflammatory and immunosuppressant

Glucocorticoids

Effects on Metabolism• Stimulation of gluconeogenesis, particularly in the liver: This

pathway results in the synthesis of glucose• Mobilization of amino acids from extra hepatic tissues• Inhibition of glucose uptake in muscle and adipose tissue: A

mechanism to conserve glucose.• Stimulation of fat breakdown in adipose tissue: The fatty acids

released by lipolysis are used for production of energy in tissues like muscle.

Glucocorticoids Mechanism

Effects on Inflammation and Immune Function• Glucocorticoids are potent anti-inflammatory, regardless of the

inflammation's cause.

Glucocorticoids Mechanism

lipocortin-1 synthesis

suppresses phospholipase A2, thereby

blocking eicosanoid production

Inhibits various leukocyte inflammatory

events

In other words, Glucocorticoids not only suppress immune response, but also inhibit the two main products of inflammation, prostaglandins and leukotrienes.

• Mineralocorticoids are a class of steroid hormones characterized by their similarity to aldosterone and their influence on salt and water balances.

• Aldosterone is produced in the cortex of the adrenal gland.

• Aldosterone acts on the kidneys to provide active reabsorption of sodium and an associated passive reabsorption of water, as well as the active secretion of potassium.

Mineralocorticoids

• Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.

Asthma

• When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

• Asthma is commonly seen in children. It is a leading cause of hospital stays and school absences. Asthma and allergies often occur together. The allergic response plays a strong role in childhood asthma.

Childhood Asthma

Common asthma triggers include:

•Animals (hair or dander)•Aspirin and other medications•Cold air, such as changes in weather (most often cold weather)•Chemicals in the air or in food•Dust, pollen

• Exercise• Mold• Strong emotions• Tobacco smoke• Viral infections, such as the

common cold

SymptomsBreathing problems are common. They can include:• Shortness of breath• Feeling like you are out of breath• Gasping for air• Having trouble breathing outOther symptoms of asthma in children include:• Coughing that sometimes wakes the child up at night• Dark bags under the eyes• Feeling tired• Irritability• Tightness in the chest• Wheezing, a whistling sound made when breathing, that may be more

noticeable when the child breathes out

Childhood Asthma

• COPD is defined as follows: a disease state characterized by airflow limitation that is not fully reversible.

• The airflow limitation is usually progressive and associated with an abnormal response of the lungs to noxious particles or gases.

Causes1. Smoking2. Occupational exposures3. Air pollution4. Genetics5. Infections6. Bronchial hyperresponsiveness (characteristic of asthma)

Chronic obstructive pulmonary disease (COPD)

Sign & Symptoms• Rapid breathing rate• Wheezing sounds or crackles in the lungs heard

through a stethoscope• Breathing out taking a longer time than breathing in• Enlargement of the chest, particularly the front-to-back

distance (hyper aeration)• Active use of muscles in the neck to help with

breathing• Breathing through pursed lips

COPD

• Both are chronic inflammatory diseases • Both resulting in small airways and cause airflow limitation• Both result from gene-environment interactions• Characterized by mucus and bronchoconstriction.

Asthma v/s COPD

Asthma COPD

Anatomical sites Affects only the airways Both the airways andthe parenchyma (Lung tissue)

Nature of inflammation

Eosinophilic driven Neutrophilic driven

Onset During childhood or adolescence

Develops in smokers and former smokers who are in their mid-40s

Cure rate Reversible Poorly reversible

Progression of Disease

Chronic but not progressive Progressive

Gene-environment interactions

Allergens cause inflammation

Particles and Gases cause inflammation

• Deflazacort is a synthetic corticosteroid.

• Deflazacort works by preventing or reducing inflammation.

• It is used to treat a number of conditions that are characterized by excessive inflammation.

• Deflazacort suppresses the immune system and so can be used to treat autoimmune diseases.

• It has been proven to having a lower risk of side effects such as bone loss, glucose intolerance or Cushing’s syndrome than other available steroids.

Deflazacort

• Chronic Obstructive Pulmonary Disease • Bronchial Asthma • Other Inflammatory disorders• Rheumatoid Arthritis • Juvenile chronic arthritis

Deflazacort Indication

• 60% Less Weight gain as compared to methylprednisolone.• Improvement in FEV1 by 22% by base line.• Calcium-sparing properties, improves on osteoporosis and vertebral collapse • Deflazacort treatment in Progressive diaphyseal dysplasia (PDD), a rare

disorder of bones, resulted in clinical and radiological improvement within 12 months with no side effects.

• A safer alternative in case of severe systemic juvenile chronic (rheumatoid) arthritis, does not make children so round faced, and may also allow them to continue to grow more normally.

• Various studies have shown that using deflazacort instead of prednisolone in kidney transplant patients helps to prevent fat accumulation and worsening of lipid profile.

• The overall incidence of adverse events in deflazacort recipients (16.5%) is lower than that recorded in patients treated with prednisone (20.5%) or methylprednisolone (32.7%) and similar to that in betamethasone recipients

Deflazacort USPs

Ensures Immense Protection

Introducing

As per ORG data currently Total Deflazacort Market is 102.6 cores and growing at the rate of promising 40%.

Market Analysis

Molecule BRANDS COMPANY DEC'09 DEC'10 GROWTH

DEFLAZACORT DEFCORT MACLEODS PHARMA 11.3 15.0 32.91

DEFLAZACORT DEFZA WALLACE 3.3 5.4 64.59

DEFLAZACORT DEZACOR ARISTO PHARMA* 3.7 4.0 8.62

DEFLAZACORT DEFNALONE LUPIN LIMITED 3.3 3.6 9.34

DEFLAZACORT CORTISURE ALEMBIC 2.5 3.3 31.64

DEFLAZACORT CORTIMAX EMCURE* 2.0 3.0 48.33

DEFLAZACORT ORTHOCORT MACLEODS PHARMA 2.1 2.8 30.20

DEFLAZACORT ENZOCORT ALKEM* 0.4 2.1 373.52

Market Intelligence

BRANDS Product Pack COMPANY MRP

DEFCORT DEFCORT TAB UNCOATED 6 MG x 6 MACLEODS PHARMA

DEFZA DEFZA TAB UNCOATED 6 MG x 6 WALLACE

DEZACOR DEZACOR TAB UNCOATED 6 MG x 10 ARISTO PHARMA*

DEFNALONE DEFNALONE TAB UNCOATED 6 MG x 10 LUPIN LIMITED

CORTISURE CORTISURE TAB UNCOATED 6 MG x 6 ALEMBIC

CORTIMAX CORTIMAX TAB UNCOATED 6 MG x 6 EMCURE*

ORTHOCORT ORTHOCORT TAB UNCOATED 6 MG x 6 MACLEODS PHARMA

ENZOCORT ENZOCORT TAB UNCOATED 6 MG x 10 ALKEM*

Brand Plan

Campaign/Activity Samples LBLs Memorable Day Campaigns Gifts Product

MonographReminder

Card

Gluticord

Sep-12 --- 90 --- --- --- --- ---

Oct-12 --- --- 30 --- --- --- ---

Nov-12 --- 90 --- --- Paper Weight --- ---

Dec-12 --- Selective --- --- --- ---Separate Reminder

Card

Detailing StoryStart detailing from the right hand side showing the image Doctor, Big Protection for Small Ones.

Start detailing from the top left hand side of VAS

Doctor, in Asthma, COPD, Allergy and Inflammatory disorders please prescribe Gluticord containing Deflazacort 6mg tablet. A Safe and Novel Corticosteroid.

Now, come to the middle part and detail

Doctor, our Gluticord ensures stronger immunosuppressive activity with anti inflammatory action. Gluticord ensures 60% lesser weight gain compared to methylprednisolone. Gluticord ensures more effectiveness than hydrocortisone in the treatment of drug resistant epilepsies with no reported adverse effects. Gluticord ensures improvement in FEV1 -22% from base line.

Show the product pack and detail Doctor, dose of Gluticord tablet is 0.25-1.5mg per kilogram per day given on alternate days.

Inform the availability and demand for prescription

Doctor, our Gluticord is readily available in ……….. Medical store to honor your prescription. Doctor, please prescribe Gluticord –Ensures Immense Protection.