Inhaled Steroids and Adrenal Function in Asthmatic Children

Abstract

Inhaled steroids are potent anti-inflammatory agents used in the treatment of asthma. One of the most important side-effects of their use is their capacity to suppress the hypothalamic-pituitary-adrenal (HPA) axis. Our study evaluated whether inhaled beclomethasone dipropionate (BDP) for a long period (1 month) at a dose >600 μg/mq/day could suppress the HPA axis and cortisol excretion. We analyzed the 24-hour urinary free cortisol excretion in 14 children (7 boys and 7 girls) receiving inhaled BDP for 1 month, at the beginning of the study, after 14 and 28 days of therapy, and 1 month after its stoppage. We found no significant difference in cortisol excretion during the study time. Our population was also divided into two groups: group A receiving a dose of inhaled BDP ≤800 μg/mq/day and group B receiving a dose >800 μg/mq/day. No significant difference in cortisol excretion was found between group A and group B. The results of our study confirm that inhaled BDP, when used at a minimal dose of 600 μg/mq/day for a long period, does not suppress the HPA axis.