Wh. Nikolaizik et al., NOCTURNAL CORTISOL SECRETION IN HEALTHY-ADULTS BEFORE AND AFTER INHALATION OF BUDESONIDE, American journal of respiratory and critical care medicine, 153(1), 1996, pp. 97-101
Citations number
22
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
We have previously demonstrated dose-dependent nocturnal cortisol supp
ression by inhaled beclomethasone and budesonide in asthmatic children
. This has now been confirmed in a controlled study. Eighteen healthy
adults inhaled either a single evening dose of 400 mu g budesonide or
placebo or 400 mu g budesonide twice daily for 2 wk. Overnight blood s
amplings for cortisol and adrenocorticotropic hormone were taken at th
e beginning of the trial, at the end of the treatment period, and afte
r stopping the medications. Compared with placebo, the nocturnal corti
sol production was significantly reduced by 40% after a single dose of
budesonide (p = 0.020) and by 37% after 2 wk of budesonide (p = 0.045
). These data indicate that there is a single-dose rather than a cumul
ative suppressive effect of inhaled corticosteroids using the specific
dose and regimen studied in this protocol. The effect is not related
to the underlying problem, namely asthma. The clinical relevance of th
ese findings can only be elucidated in long-term follow-up studies. We
believe that our findings explain the recent identification of abnorm
alities in bone turnover on inhaled corticosteroids in the absence of
other systemic effects. The findings emphasize the need for a cautious
step-wise approach to asthma therapy.