Effects of cloprednol and other corticosteroids on hypothalamic-pituitary-adrenal axis function.
The effects of cloprednol and other corticosteroids on hypothalamic-pituitary-adrenal (HPA) function were studied in healthy subjects after administration of a single oral dose of corticosteroid at 6 a.m. or 6 p.m., and after daily 6 a.m. administration of corticosteroids at various doses for seven days. The degree of HPA suppression was assessed by metyrapone tests (METP), insulin hypoglycaemia tests (IHT) and 6 a.m. fasting plasma cortisol concentrations. Regardless of the corticosteroid tested, 6 p.m. dosing was at least four-fold more suppressive of METP response than 6 a.m. administration. At therapeutically equivalent doses, single doses of triamcinolone and dexamethasone were more suppressive of HPA-axis function than cloprednol, hydrocortisone or prednisolone, After 6 a.m. administration for seven days, 12-5 mg of cloprednol did not impair the cortisol response to IHT or interfere with the METP response. The clinically equivalent dose of prednisolone (25 mg) resulted in slightly greater HPA-axis suppression. All doses of dexamethasone (0-5, 3-75 and 6-0 mg) and of betamethasome (2-0, 4-0 and 6-5 mg) were more suppressive of HPA-axis function than either cloprednol or prednisolone. These results suggest that at equipotent anti-inflammatory doses, cloprednol is slightly less suppressive of HPA-axis function than prednisolone, and both cloprednol and prednisolone are much less suppressive than dexamethasone or betamethasone.
D000293:Adolescent; D000311:Adrenal Glands / Q000187:drug effects*; D000328:Adult; D001623:Betamethasone / Q000494:pharmacology; D003907:Dexamethasone / Q000494:pharmacology; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000494:pharmacology; D007031:Hypothalamus / Q000187:drug effects*; D007328:Insulin; D008297:Male; D008797:Metyrapone; D010902:Pituitary Gland / Q000187:drug effects*; D011239:Prednisolone / Q000494:pharmacology; D011282:Pregnenediones / Q000494:pharmacology*; D013997:Time Factors; D014221:Triamcinolone / Q000494:pharmacology
D005938:Glucocorticoids; D007328:Insulin; D011282:Pregnenediones; D014221:Triamcinolone; D003907:Dexamethasone; D001623:Betamethasone; D011239:Prednisolone; D006854:Hydrocortisone; D008797:Metyrapone