Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.14279/1224
Title: Adrenal function and high dose inhaled corticosteroids for asthma
Authors: Milner, Anthony D. 
Conway, Elvira 
Honour, John W. 
Yiallouros, Panayiotis K. 
metadata.dc.contributor.other: Γιάλλουρος, Παναγιώτης
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Inhaled corticosteroids;Adrenal function;Spacer devices
Issue Date: May-1997
Source: Archives of Disease in Childhood, 1997, vol. 76, no. 5, pp. 405–410
Volume: 76
Issue: 5
Start page: 405
End page: 410
Journal: Archives of Disease in Childhood 
Abstract: Objective—To investigate eVects on adrenal function of fluticasone, a recently released inhaled steroid preparation with lower systemic bioavailability than beclomethasone dipropionate. Methods—34 children on high doses (400- 909 µg/m2 /d) of inhaled beclomethasone dipropionate or budesonide were recruited into a double blind, crossover study investigating the eVects on adrenal function of beclomethasone and fluticasone propionate, given using a standard spacer (Volumatic). The 24 hour excretion rates of total cortisol and cortisol metabolites were determined at baseline (after a two week run in), after six weeks treatment with an equal dose of beclomethasone, and after six weeks of treatment with half the dose of fluticasone, both given through a spacer device. Results—The comparison of eVects between fluticasone and beclomethasone during treatment periods, although favouring fluticasone in all measured variables, reached significance only after correction for urinary creatinine excretion (tetrahydrocortisol and 5á-tetrahydrocortisol geometric means: 424 v 341 µg/m2 /d). The baseline data showed adrenal suppression in the children taking beclomethasone (total cortisol geometric means: 975 v 1542 µg/d) and a dose related suppression in the children taking budesonide. Suppressed adrenal function in the children who were taking beclomethasone at baseline subsequently improved with fluticasone and beclomethasone during treatment periods. Conclusions—Fluticasone is less likely to suppress adrenal function than beclomethasone at therapeutically equivalent doses. The baseline data also support the claim that spacer devices should be used for the administration of high doses of inhaled topical steroids
URI: https://hdl.handle.net/20.500.14279/1224
ISSN: 14682044
DOI: 10.1136/adc.76.5.405
Rights: © BMJ Publishing Group
Type: Article
Affiliation : University of London 
University College London 
Appears in Collections:Άρθρα/Articles

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