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Adrenal function of children with bronchial asthma treated with beclomethasone dipropionate
T Katsunuma1, A Akasawa, Y Iikura
1Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
Insights
Inhaled beclomethasone dipropionate at 300 micrograms daily for 12 weeks did not suppress the hypothalamic-pituitary-adrenal (HPA) axis in children with asthma. This study indicates safety for this common asthma treatment in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Respiratory Medicine
- Pharmacology
Background:
- Asthma is a common chronic respiratory disease in children.
- Inhaled corticosteroids are a mainstay treatment for persistent asthma.
- The hypothalamic-pituitary-adrenal (HPA) axis is crucial for stress response and metabolism.
Purpose of the Study:
- To evaluate the effect of inhaled beclomethasone dipropionate on HPA axis function in asthmatic children.
- To determine if a 300 mcg/day dose of inhaled beclomethasone causes HPA axis suppression.
Main Methods:
- Prospective study involving nine asthmatic children.
- Measurements included 24-hour urinary free cortisol, serum cortisol, ACTH response, and nocturnal serum cortisol.
- Assessments were conducted before and after a 12-week treatment period with inhaled beclomethasone dipropionate (300 mcg/day).
Main Results:
- No significant changes were observed in any of the HPA axis function markers.
- 24-hour urinary free cortisol remained stable.
- Serum cortisol levels and ACTH response showed no significant alterations.
Conclusions:
- Inhaled beclomethasone dipropionate, at a daily dose of 300 micrograms, does not appear to suppress the HPA axis in children with asthma.
- This finding supports the safety profile of low-dose inhaled beclomethasone for long-term use in pediatric asthma management.
Abstract:
The function of the hypothalamic-pituitary-adrenal (HPA) axis was investigated in nine asthmatic children treated by inhalation of beclomethasone dipropionate (300 micrograms/day) for 12 weeks. The trial was designed as a prospective study. The 24-hour urinary free cortisol, serum cortisol, response to ACTH, and nocturnal serum cortisol followed by 20-minute sampling were measured before and after the study period. No significant changes were found, suggesting that inhaled beclomethasone, in a daily dose of 300 micrograms, does not cause suppression of the HPA axis.