Effect of Inhaled Fluticasone Propionate on Hypothalamic-Pituitary-Adrenal Axis in Bronchial Asthma Patient.
10.4046/trd.2001.51.1.25
- Author:
Jun Kyu HWANG
;
Ho Meong LEE
;
Yang Won NO
;
Gye Young PARK
;
Chong Wung PARK
;
Jae Kyung PARK
;
Seong Hwan JEONG
;
Gui Hyun NAM
;
Hong Kyu KIM
;
Hye Young PARK
;
Moon Ho KANG
- Publication Type:Original Article
- Keywords:
Inhaled corticosteroid;
Fluticasone propionate;
Hypothalamic-pituitary-adrenal axis suppression
- MeSH:
Adrenal Cortex Hormones;
Adrenocorticotropic Hormone;
Asthma*;
Axis, Cervical Vertebra*;
Cosyntropin;
Diethylpropion*;
Glucocorticoids;
Humans;
Hydrocortisone;
Injections, Intramuscular;
Reference Values;
Fluticasone
- From:Tuberculosis and Respiratory Diseases
2001;51(1):25-34
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. METHOD: This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from 200 µg to 750 µg daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. RESULT: The mean dose of inhaled fluticasone propionate was 355 µg per day(SD=174 µg, range=200 µg to 750 µg). The mean serum cortisol levels of the patients was 11.0 µg/dl(SD=6.4 µg/dl) prior to the injection, 20.0 µg/dl(SD=7.7 µg/dl) after 30 minutes, and 23.0 µg/dl(SD=6.3 µg/dl) after 60 minutes. Sixteen patients of the 21 patients had a normal response(>18 µg/dl), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. CONCLUSION: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.
