A comparison of the effects of oral prednisone and inhaled beclomethasone dipropionate on circulating leukocytes.
BACKGROUND
While the side effects of oral glucocorticoids are well recognised there is debate about the systemic effects of high doses of inhaled glucocorticoids such as beclomethasone dipropionate and how these compare with the effects of oral prednisone.


OBJECTIVE
To compare the effects of different doses of oral prednisone and inhaled beclomethasone dipropionate (BDP) on changes in circulating leukocytes.


METHODS
Changes in different subsets of circulating leukocytes were measured as an index of the systemic effects of inhaled BDP and oral prednisone. We compared the effects of inhaled placebo and 500 and 1000 micrograms of inhaled BDP with oral placebo and 2.5, 5 and 10 mg of prednisone in eight healthy volunteers. Leukocyte numbers were measured before and four hours after each dose of medicine.


RESULTS
Compared with inhaled placebo, 1000 micrograms of inhaled BDP led to a significant increase in neutrophils as a percentage of the total white count (p < 0.05) and a significant decrease in the total lymphocyte number (p < 0.05) and in the number of CD4 lymphocytes (p < 0.05). For 1000 micrograms BDP the increase in the % neutrophil count was 8.55% (95% CI 5.17 to 11.93) and the fall in lymphocyte numbers was -0.14 x 10(9)/L (95% CI 0.06 to -0.34) while 2.5 mg prednisone led to an increase in the % neutrophil count of 9.31% (95% CI 5.82 to 12.80) and a fall in lymphocyte numbers of -0.07 x 10(9)/L (95% CI 0.05 to -0.19).


CONCLUSIONS
The systemic effects of 1000 micrograms inhaled BDP and 2.5 mg of prednisone are similar.
Cameron
R G
RG
University of Auckland, New Zealand.
Black
P N
PN
Braan
C
C
Browett
P J
PJ
D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D001507:Beclomethasone / Q000008:administration & dosage*; D016001:Confidence Intervals; D004311:Double-Blind Method; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D007962:Leukocytes / Q000187:drug effects*; D015999:Multivariate Analysis; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D001507:Beclomethasone; D011241:Prednisone