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Adrenal function improves in asthmatic children on inhaled steroids: a longitudinal study
Kostas N Priftis1, Anastasios Papadimitriou, Michael B Anthracopoulos
1Department of Allergy and Pneumonology, P. Penteli Children's Hospital, Penteli, Greece. kpriftis@otenet.gr
Neuroimmunomodulation
|July 26, 2006
Summary
Inhaled corticosteroids (ICS) may affect adrenal function in children with asthma. While some asthmatic children show improved adrenal response with long-term ICS, others may experience distinct adrenal suppression.
Area of Science:
- Pediatric Endocrinology
- Respiratory Medicine
- Pharmacology
Background:
- Asthmatic children on long-term inhaled corticosteroids (ICS) may experience mild adrenal suppression.
- Individual variations in baseline adrenal function among asthmatic children may exist.
- ICS therapy might accentuate pre-existing differences in adrenal function.
Purpose of the Study:
- To investigate baseline adrenal function in prepubertal asthmatic children.
- To determine the impact of long-term inhaled budesonide on adrenal function over 12 months.
- To test if ICS therapy accentuates lower baseline adrenal function.
Main Methods:
- A low-dose Synacthen test was administered to 41 prepubertal asthmatic children.
- Tests were conducted before ICS treatment, and at 6 and 12 months of budesonide therapy (400 microg/day).
- Follow-up data were collected from 34 children due to withdrawals.
Main Results:
- Low adrenal function was observed in 9.8% at baseline and 22.2% at 6 months.
- Adrenal function normalized in 4 children by 6 months.
- 17.6% showed suppressed adrenal function at 12 months, with 3 having prior suppression; however, excluding suppressed cases showed improved peak cortisol values.
Conclusions:
- Long-term inhaled corticosteroid (ICS) treatment often leads to improved adrenal response in asthmatic children.
- Adrenal suppression observed in some patients on maintenance ICS appears to be a distinct phenomenon.
- Individual adrenal function variability warrants consideration in pediatric asthma management.
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