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Copyright ©ERS Journals Ltd 2003
Adrenal suppression from high-dose inhaled fluticasone propionate in children with asthma
Depts of 1 Respiratory and Sleep Medicine and 2 Paediatric Endocrinology, Monash Medical Centre and 3 Centre for Heart and Chest Research, Monash University, Melbourne, Australia
CORRESPONDENCE: N. Freezer, Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, Australia. Fax: 61 395946415. E-mail: n.freezer@southernhealth.org.au
Keywords: adrenal suppression, asthma, children, flixotide
Received: January 3, 2002
Accepted May 25, 2002
This cross-sectional study was designed to examine the prevalence of adrenocortical suppression in children with asthma treated with high-dose inhaled fluticasone propionate (FP).
Children and adolescents (n=50) with asthma, treated with inhaled FP at a dose of
Fifty subjects of mean age 13.1 yrs were treated with a mean dose of 924.7 µg·m–2·day–1 FP for a mean duration of 2 yrs. Of the 50 subjects, 36 (72%) had serum cortisol levels of <400 nmol·L–1 and underwent tetracosactrin stimulation test. Of these, 6 (17%) demonstrated a less than two-fold increase in serum cortisol from baseline and peak cortisol level of
Biochemical evidence of adrenocortical insufficiency was demonstrated in 12% of the subjects, indicating that high-dose fluticasone propionate use may be associated with dose-dependent adrenocortical suppression.
1,000 mg a day for 6 months, were enrolled. Early morning serum cortisol was performed. Subjects with a serum cortisol of <400 nmol·L–1 had a tetracosactrin stimulation test. 
550 nmol·L–1 at 30 or 60 min poststimulation. There was a significant negative correlation between the dose of FP·m–2 and stimulated peak cortisol level.
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