Suppressive effects of long-term treatment with inhaled steroids on hypothalamic-pituitary-adrenal axis in asthma
Allergy, Asthma & Respiratory Disease
;
: 285-292, 2014.
Article
in Korean
| WPRIM
| ID: wpr-29501
ABSTRACT
PURPOSE:
Long-term treatment with inhaled steroids (ICS), especially fluticasone that developed lately, may suppress the hypothalamic-pituitary-adrenal (HPA) axis. This study investigated the relationship between ICS use and HPA axis suppression in asthmatics under ICS treatment for average 4.5 years.METHODS:
The medical records of 129 adult asthmatics who received ICS treatment for 6 months or more and underwent a corticotropin stimulation test from January 2005 to August 2013 were retrospectively reviewed.RESULTS:
The patients received ICS only (n=87) were found to have an abnormal response to the corticotropin test in as high as 32.2%, and those received ICS in combination with oral steroids (n=42) had a significantly higher prevalence of the response (71.4%, P<0.001). Abnormal responses to corticotropin occurred depending on ICS daily doses (low, n=8, 12.5%; medium, n=19, 36.8%; high, n=102, 49.0%; chi2=4.384, P=0.036). Among the subjects received ICS only, nasal steroid doses (P=0.016) but not ICS doses (P=0.159) were significantly higher in those with abnormal responses than the others. Among all the subjects, oral steroid use (odds ratio [OR], 4.27; 95% confidence interval [CI], 2.35-11.80; P<0.001) and nasal steroid dose (OR, 1.02; 95% CI, 1.00-1.04; P=0.015) were significant risk factors for HPA axis suppression.CONCLUSION:
One-third of asthmatics under long-term treatment with ICS showed a suppression of the HPA axis in a dose-dependent manner. Oral or nasal steroid use may be a risk factor for the suppression. However, since our results may have been overestimated due to subject selection bias, further prospective case-control studies are warranted.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Asthma
/
Steroids
/
Axis, Cervical Vertebra
/
Case-Control Studies
/
Selection Bias
/
Medical Records
/
Prevalence
/
Retrospective Studies
/
Risk Factors
/
Adrenal Glands
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Adult
/
Humans
Language:
Korean
Journal:
Allergy, Asthma & Respiratory Disease
Year:
2014
Type:
Article
Similar
MEDLINE
...
LILACS
LIS