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Adrenal function in asthmatic children treated with inhaled budesonide
H Bisgaard1, S Pedersen, M Damkjaer Nielsen
1Department of Paediatrics, University Hospital of Copenhagen, Denmark.
Acta Paediatrica Scandinavica
|February 1, 1991
Summary
Inhaled budesonide, a topical steroid, did not significantly suppress adrenal function in children with asthma, even at higher doses. This suggests budesonide has a favorable safety profile for managing pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Endocrinology
Background:
- Asthma management in children often involves inhaled corticosteroids.
- Concerns exist regarding potential systemic side effects of inhaled steroids, specifically adrenal suppression.
Purpose of the Study:
- To evaluate the effect of inhaled budesonide on adrenal function in children with moderate bronchial asthma.
- To determine if increasing doses of budesonide lead to dose-related suppression of cortisol production.
Main Methods:
- Prospective, single-blind study involving 33 children (7-15 years) with moderate asthma.
- Treatment with budesonide at daily doses of 200, 400, and 800 micrograms over three randomized 8-week periods.
- Assessment of unstimulated diurnal cortisol production via 24-hour urinary free cortisol measurements.
Main Results:
- No significant dose-related suppression of cortisol production was observed.
- Cortisol production did not significantly differ between the 200 microgram and 800 microgram budesonide treatment groups (95% CI: 74%-112%).
Conclusions:
- Inhaled budesonide demonstrates a favorable ratio of topical to systemic effects in pediatric asthma patients.
- Budesonide appears to be a safe option for managing moderate bronchial asthma in children, with minimal impact on adrenal function.