Abstract
To assess the effect of long term therapy with inhaled beclomethasone dipropionate (BDP) on the pituitary-adrenal axis we measured the integrate concentration of plasma Cortisol level (ICPCL) in 8 asthmatic children (aged 6-16 yrs) who received BDP doses of 200-600 μg/d for 6-48 mos. Controls were 4 children (aged 6-16 yrs) whose ICPCL measured for other reasons were normal. All patients did not receive any oral steroids during the 3 months prior to the study. The ICPCL was determined using a portable withdrawal pump to enable continuous blood specimen collection (every 1/2h) for 24 h. mean ICPCL. Mean ICPCL of the asthmatic children on long term BDP therapy was significantly low (4.9 ± 3-3 μg%, mean±S.D.) as compared to the healthy controls (8.7±2 μg%)(p<0.05, Mann-Whitney U-test). In 5/8 asthmatics the ICPCL was lower than the mean -2SD of the controls: 1.6;2.8;3.1; 3.6;3.8 μg%. Response of Cortisol secretion to IV administration of 0.25 mg ACTH was abnormal in two of the five asthmatic children with low ICPCL. No correlation was found between ICPCL and severity of the asthma, height percentile and the tunner stage.
We conclude that long term therapy with inhaled BDP may cause reduction in the normal physiological secretion of Cortisol even with relatively low doses. This effect is probably due to partial depression of the pituitary-adrenal axis.
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Phillip, M., Tal, A., Leiberman, E. et al. 158 INTEGRATED CONCENTRATION OF PLASMA CORTISOL LEVEL IN ASTHMATIC CHILDREN TREATED WITH LONG TERM INHALED STEROIDS. Pediatr Res 24, 543 (1988). https://doi.org/10.1203/00006450-198810000-00179
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DOI: https://doi.org/10.1203/00006450-198810000-00179
