ackground : Topical inhaled steroids, budesonide (BU) and beclomethasone dipropionate (BDP) is now established in the management of chronic asthma. These have high topical anti-inflammatory activity but low systemic activity. This study was
performed to
determine the effects of two inhaled corticosteroids, Bu and BDP, on the adrenocortical supression in thirty patients, eighteen chronic obstructive pumonary diseases and twelve bronchial asthma (aged 33-76 years).
Methods : The adrenocortical function was assessed by measurement of plasma cortisol
concentration at 8 o'clock in mornig and free cortisol in 24-hour urine collection at interval.
No steroid was taken during the pretreatment period of 10 days, thereafter each subjec
tinhaled Bu or BDP aerosol, in daily doses of 800 or 1,600 micrograms for 12 days. The dose
was delieved by metered dose inhaler (MDI) or diskhaler. No steroid was taken during the
final 6 days of the study.
Results : The plasma cortisol and 24-hour urinary free cortisol were decreased during the
treatment period in patients inhaled Bu in daily doses of 800 and 1,600 micrograms. In
contrast, plasma cortisol was decreased on the 12th day of treatment period in patients
inhaled BDP, in daily doses of 800 micrograms (P less than 0.05). The plasma cortisol and
24-hour urinary free cortisol were decreased (P less than 0.05) on the 9 and 12th day of
treatment period in patients inhaled BDP in daily doses of 1,600 micrograms.
Conclusion : These results suggested that suppression of the endogenous cortisol secretion
occurs at inhaled budesonide and beclomethasone dipropionate is less suppressed on the
adrenocortical function than budesonide in dose dependent fashion during the early periods.
|