TY - JOUR T1 - Adrenal suppression from high-dose inhaled fluticasone propionate in children with asthma JF - European Respiratory Journal JO - Eur Respir J SP - 633 LP - 636 DO - 10.1183/09031936.03.00306302 VL - 21 IS - 4 AU - D. Sim AU - A. Griffiths AU - D. Armstrong AU - C. Clarke AU - C. Rodda AU - N. Freezer Y1 - 2003/04/01 UR - http://erj.ersjournals.com/content/21/4/633.abstract N2 - 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 ≥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. 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 ≤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. 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. ER -