Adrenal suppression by inhaled corticosteroids in patients with asthma: A systematic review and quantitative analysis

Allergy and Asthma Proceedings
Marek L KowalskiPrzemyslaw Rys

Abstract

Inhaled corticosteroids used for treating persistent asthma can suppress adrenal cortisol secretion. This inhibition of endogenous cortisol secretion is an important marker of systemic steroid activity. Although meta-analyses have demonstrated a dose-dependent suppression of cortisol by inhaled corticosteroids, regardless of inhaler type, the impact of novel freon-free inhaled corticosteroid preparations has not been reviewed. The aim of this study was to synthesize all currently available studies on novel inhaled corticosteroid preparations, including ciclesonide, beclomethasone dipropionate, budesonide, and fluticasone propionate. In particular, we aimed to compare the effect of ciclesonide on cortisol suppression with other existing preparations. We carried out a systematic review of the medical data bases on cortisol suppression in patients due to inhaled corticosteroids. A multivariate regression model was used to determine dose-dependent relationships between each inhaled corticosteroid and cortisol suppression with respect to age, type of inhaler, and study design. From analysis of 64 studies identified in the review, the strongest dose-response urinary cortisol suppression was observed in patients treated with beclometh...Continue Reading

Citations

Oct 21, 2017·International Journal of Molecular Sciences·Rosa Maria ParagliolaSalvatore Maria Corsello
Oct 28, 2019·Pediatric Pulmonology·Esmé J BaanHettie M Janssens
Jan 9, 2020·Current Sports Medicine Reports·Weston T NorthamKevin Carneiro
Jun 11, 2020·Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology·Caroline Jane LodgeShyamali Chandrika Dharmage
Jul 21, 2020·Expert Opinion on Pharmacotherapy·Timothy E AlbertsonSusan Murin
Aug 19, 2020·Expert Opinion on Pharmacotherapy·Josuel OraPaola Rogliani
Jul 6, 2019·Frontiers in Pharmacology·Chunfa ChenJinhua Shen

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