Study on serum and urinary cortisol levels of asthmatic patients after treatment with high dose inhaled beclomethasone dipropionate or budesonide.
BACKGROUND
The potential for long-term adverse effects from inhaled corticosteroids relates to their systemic absorption. With increasing use of high dose inhaled corticosteroids, there is need to establish whether similar doses of beclomethasone dipropionate (BDP) and budesonide (BUD) produce clinically important differences in untoward side effects specially hypothalamo-pituitary-adrenal (HPA) axis suppression.


METHODS
Fifteen asthmatic patients were started on BDP or BUD (2000 microg/day) through spacer for six weeks. Serum cortisol (9 AM and 4 PM), 24-hour urinary steroid and pulmonary function testing parameters were performed.


RESULTS
The serum cortisol levels were not found to be suppressed with either BDP or BUD. Similarly no significant changes were found in 24 hours urinary excretion of steroids with either of the drugs. Significant improvement was found in values of forced expiratory volume in the first second (FEV1) with BDP. With BUD the changes in forced vital capacity (FVC) and FEV1 were found to be significant.


CONCLUSIONS
BDP or BUD in high doses of 2000 microg/day given upto six weeks through spacer are equally effective for treatment of bronchial asthma and do not cause any significant change in serum and urinary cortisol levels, and adrenal function/HPA axis.
Kaur
Charanjeet
C
Department of Biochemistry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Bansal
S K
SK
Chhabra
S K
SK
D000280:Administration, Inhalation; D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D019819:Budesonide / Q000008:administration & dosage*; D003348:Cortisone / Q000097:blood*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011336:Probability; D012016:Reference Values; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015415:Biomarkers; D019819:Budesonide; D001507:Beclomethasone; D003348:Cortisone