0
Abstract: Poster Presentations |

ADRENAL SUPPRESSION AND ITS PATTERN WITH HIGH DOSE INHALED BUDESONIDE AND FLUTICASONE PROPIONATE IN ADULT ASTHMATIC PATIENTS FREE TO VIEW

Ramakant Dixit, MBBS, MD*; Kalpana Dixit, MBBS, MD; Sidharth Sharma, MBBS, MD; Nalin Joshi, MBBS, MD
Author and Funding Information

Department of Respiratory Medicine and Tuberculosis, JLN Medical College, Ajmer, Ajmer, India


Chest


Chest. 2007;132(4_MeetingAbstracts):505a. doi:10.1378/chest.132.4_MeetingAbstracts.505a
Text Size: A A A
Published online

Abstract

PURPOSE: Inhaled corticosteroids (ICS) are the mainstay of asthma therapy now- a- days. The potential for long-term adverse effects from ICS relates to their systemic absorption. With increasing use of ICS, there is always some risk of systemic absorption of these drugs.

METHODS: We compared the risk of adrenal suppression in 24 stable asthmatic adults of mean age 31.2 years with forced expiratory volume in one second (FEV1) 86% predicted and mid expiratory flow (FEF 25–75) 57.8% predicted, receiving inhaled budesonide and fluticasone propionate in doses of > 1500 to 2000 micrograms by metered dose inhaler in a double blind, placebo controlled design. Overnight urinary cortisol levels were measured at baseline, 4 week and 12 week intervals along with clinical and spirometric monitoring.

RESULTS: The mean overnight urinary cortisol level (n mol/12 hour) were: budesonide group-baseline (26.1), 4 week (21.3), 12 week (18.6), whereas fluticasone propionate group- baseline (26.3), 4 week (15.7) and 12 week (19.8) compared with placebo group- baseline (26.5), 4 week (26.8) and 12 week (26.3). One patient each receiving budesonide and fluticasone propionate developed clinical symptoms i.e. giddiness, fatigue, fall down and hypo tension during study period without any other obvious reason. Equal improvement was found in spirometric parameters in both drug groups.

CONCLUSION: Adrenal suppression is not uncommon with chronic high dose ICS therapy. This is more marked with fluticasone propionate especially during early phase of treatment, however, in long-term treatment, budesonide may cause more adrenal suppression. Such event during long-term high dose ICS therapy may prove clinically significant at the time of stress where it may produce acute adrenal crisis.

CLINICAL IMPLICATIONS: Patients receiving high dose ICS therapy should be educated regarding possible risk of adrenal suppression and systemic side effects while taking unsupervised therapy.

DISCLOSURE: Dr.Ramakant Dixit, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, October 24, 2007

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
Guidelines
Asthma in pregnancy.
American College of Obstetricians and Gynecologists | 9/19/2008
Inhaled corticosteroids for the treatment of chronic asthma in children under the age of 12 years.
National Institute for Health and Clinical Excellence (NICE) | 1/31/2008
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543