+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma



Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma



Thorax 48(6): 599-602



Background - Childhood asthma generally responds well to inhaled corticosteroids within the dosage range recommended by the manufacturers, but it is sometimes necessary to use higher doses (that is, above 400 mu-g/day), a practice which has become more widespread recently. Whereas the lack of adrenal suppression in children given inhaled corticosteroids in normal doses is well documented, little is known about the effects of higher doses. Methods - The effects on adrenal function of high dose (above 400 mu-g/day) inhaled corticosteroids were evaluated by measuring cortisol concentration in the morning and performing a short tetracosactrin test in 49 children taking budesonide (mean age 9.2 years (range 4 to 16 years) and 28 children taking beclomethasone dipropionate (10.2 years (5 to 13 years)). Twenty three non-asthmatic children (8.9 years (4.9 to 13 years)) who were under investigation for short stature served as controls for the study. Results - Compared with controls mean basal cortisol concentration was lower in children taking budesonide and beclomethasone dipropionate (control 401 (26.8) nmol/l, budesonide 284 (22) nmol/l, beclomethasone dipropionate 279 (23.2) nmol/l). Sixteen of the 49 children taking budesonide had subnormal basal cortisol concentrations compared with seven of the 28 taking beclomethasone dipropionate. Mean stimulated cortisol concentrations were lower in children taking inhaled corticosteroids than in controls, with no difference between those taking budesonide or beclomethasone dipropionate. Conclusions - Adrenal suppression occurs in some children who are given inhaled corticosteroids in doses greater than 400 mu-g/day. It may therefore be advisable to try alternative treatments before such doses are used.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 008569441

Download citation: RISBibTeXText

PMID: 8346487

DOI: 10.1136/thx.48.6.599


Related references

High doses of inhaled budesonide and adrenal function in children with severe asthma. Revista Medica de Chile 134(1): 60-64, 2006

Formoterol (Foradil) and medium-high doses of inhaled corticosteroids are more effective than high doses of corticosteroids in moderate-to-severe asthma. Pulmonary Pharmacology & Therapeutics 16(5): 299-306, 2003

High doses of the novel inhaled steroid ciclesonide have no effect on HPA-axis function in patients with moderate-to-severe persistent asthma. Journal of Allergy & Clinical Immunology 111(2 Abstract Supplement): S216, February, 2003

Combination regimens of the inhaled preparation ie; salbutamol with corticosteroids proved more effective in relieving severe bronchial asthma than high doses of corticosteroids alone. Chest 118(4 Suppl ): 189S, October, 2000

Effect of high doses of inhaled flunisolide on hypothalamic pituitary adrenal axis function in children with asthma. Current Therapeutic Research 49(5): 778-791, 1991

Adrenal function and high dose inhaled corticosteroids for asthma. Archives of Disease in Childhood 76(5): 405-410, 1997

The effects on growth of inhaled corticosteroids in children with persistent asthma. American Journal of Nursing 115(6): 21-21, 2015

Inhaled corticosteroids in children with persistent asthma: effects on growth. Evidence-Based Child Health 9(4): 829-930, 2014

Inhaled corticosteroids in children with persistent asthma: Effects on growth. Paediatrics & Child Health 20(5): 248-250, 2015

Inhaled corticosteroids in children with persistent asthma: effects on growth. Cochrane Database of Systematic Reviews 2015(7): Cd009471-Cd009471, 2015

Normal lung function in children with mild to moderate persistent asthma well controlled by inhaled corticosteroids. Journal of Allergy and Clinical Immunology 118(1): 280-282, 2006

Effects of inhaled mometasone furoate on growth velocity and adrenal function: a placebo-controlled trial in children 4-9 years old with mild persistent asthma. Journal of Asthma 48(8): 848-859, 2011

Adrenal crises in children treated with high-dose inhaled corticosteroids for asthma. Medical Journal of Australia 178(5): 214-216, 2003

Adrenal function in children with severe asthma treated with high-dose inhaled glucocorticoids: recommended screening tests in outpatient conditions. Journal of Pediatric Endocrinology & Metabolism 20(7): 781-789, 2007

In patients with stable persistent asthma, can lower doses of inhaled corticosteroid medication control symptoms and maintain optimal pulmonary function as well as high doses?. Journal of Family Practice 49(6): 494-495, 2000