Adrenal Function in Children with Asthma and Allergic Rhinitis Treated with Combination of Inhaled and Nasal Corticosteroids

Abstract

Introduction: Children with asthma and allergic rhinitis are often treated with a combination of inhaled and nasal corticosteroids. Safety data on this combination treatment in children are not available. This study evaluates adrenal function in children receiving combination therapy with nasal and inhaled corticosteroid using a low-dose adrenocorticotropin (ACTH) test. Methods: Twelve children aged 6–12 years with severe asthma and allergic rhinitis were given combination therapy with high-dose inhaled HFA-beclomethasone dipropionate (HFA-BDP) (320 μg/day for first 2 months and 160 μg/day thereafter) and flunisolide nasal spray (116 μg/day). A low-dose ACTH test was performed before treatment and 6 months later. Results: There was no significant change (mean ± SD) in both baseline (7.78 ± 5.34 before treatment and 7.53 ± 4.02 after treatment, p = 0.42) and stimulated (22.58 ± 6.97 before treatment and 19.2 ± 3.53, p = 0.09 after treatment) cortisol levels. Conclusion: Combination therapy with high-dose HFA-BDP and flunisolide nasal spray did not cause suppression of adrenal function in pediatric patients with severe asthma and allergic rhinitis.