title: Assessment of systemic effects of inhaled glucocorticosteroids: comparison of the effects of inhaled budesonide and oral prednisolone on adrenal function and markers of bone turnover.
abstract: The effects of inhaled budesonide (BUD) and oral prednisolone (PRED) on markers of bone turnover and adrenal function were compared in a randomized, double-blind, double-dummy, crossover study. Twelve healthy subjects were treated for one week with 0.8, 1.6 and 3.2 mg/day BUD and 5, 10 and 20 mg/day PRED, the three doses being given in ascending order. Plasma cortisol and adrenal cortical androgens showed a significantly decreasing trend with the increasing doses of both drugs, although PRED caused a significantly greater decrease than BUD. Osteoblast function, reflected by serum osteocalcin and alkaline phosphatase was significantly reduced by PRED, but BUD had a significantly different effect as it affected only osteocalcin. Urinary hydroxyproline/creatinine, a marker of bone resorption, was not changed by either drug. The average potency ratio for equivalent systemic effects was PRED:BUD 3.9:1. During short-term treatment at equivalent anti-asthmatic doses, BUD has significantly less effect on adrenal function and bone turnover than PRED, and it may carry less risk of bone complications during long-term treatment.
authors.affiliation: Department of Clinical Pharmacology, University Hospital, Lund, Sweden.
authors.forename: B H
authors.initials: BH
authors.lastname: Jennings
authors.forename: K E
authors.initials: KE
authors.lastname: Andersson
authors.forename: S A
authors.initials: SA
authors.lastname: Johansson
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000287:Administration, Topical; D000311:Adrenal Glands / Q000187:drug effects*; D000328:Adult; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001862:Bone Resorption / Q000139:chemically induced; D001842:Bone and Bones / Q000187:drug effects*; D019819:Budesonide; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology*; D011282:Pregnenediones / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D000893:Anti-Inflammatory Agents; D011282:Pregnenediones; D015675:Osteocalcin; D019819:Budesonide; D011239:Prednisolone; D006854:Hydrocortisone