Is adrenal suppression
in asthmatic children reversible?
Corticosteroids are synthetic forms of cortisol.2 They are usually prescribed in a once a day regimen to match the normal circadian rhythm of steroid hormones and to avoid adrenal suppression
.4 Despite being life-saving, steroids have many adverse effects.
Unfortunately, corticosteroids can also cause side effects, one of which is adrenal suppression
, seen in up to 1/3 of people tested.
In a world first, the University of Liverpool researchers, led by Sir Munir Pirmohamed, conducted a genome-wide association study (GWAS) to pinpoint the genes responsible for increasing the risk of a person developing adrenal suppression
They might have some value to check the grade of adrenal suppression
they may cause.
Trials on the use of ICSs in CF for the treatment of allergic bronchopulmonary aspergillosis did not systematically evaluate adverse events, although the total daily dose of ICSs was at the threshold of adrenal suppression
in most studies .
What many of these cases share is the inhibition of CYP3A4 which results in supraphysiologic levels of corticosteroids (inhaled, intranasal, intra-articular, or oral) leading to iatrogenic Cushing's syndrome with resultant adrenal suppression
. There are also case reports of itraconazole-induced central adrenal insufficiency, but in all cases, it was thought to be due to a drug interaction with inhaled corticosteroids [13, 14].
Suppression of HPA axis is a well-known and tested effect of exogenous therapy with glucocorticoids (GCs) and GC therapy is the most common cause of adrenal suppression
The prescribing information says that mometasone furoate exerts less effect on the hypothalamic-pituitary-adrenal axis than other inhaled corticosteroids, and that adrenal suppression
is unlikely to occur when used at recommended dosages.
Patients taking steroids have a significant risk of Adrenal suppression
caused due to suppression of hypothalamic pituitary axis leading to adrenal insufficiency.
Seven studies with a primary end-point of adrenal suppression
performed on 1303 patients were analyzed separately.
levels of serum cortisol; taken at 0800 hrs following 3 weeks of treatment, less than 3 ug/dl (83nmol/l) was taken as cases of adrenal suppression