Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease

Fahim, Ahmed; Faruqi, Shoaib; Wright, Caroline E.; Kastelik, Jack A.; Morice, Alyn H.

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of respiratory-related morbidity and mortality. Inhaled steroids are frequently used in patients with moderate to severe disease and may lead to adrenal suppression. Objectives: The aim of this study was to compare the effect of inhaled budesonide/formoterol with inhaled fluticasone/salmeterol in severe COPD. Methods: It was a prospective open-label crossover study of 22 patients. Adrenal suppression was measured by overnight urinary cortisol/creatinine ratio. The measurements were taken while patients were on either combination for at least 4 weeks. Results: A total of 12 patients completed the study. The mean age was 64 years (8 males, 4 females). The mean FEV1 was 1 L (range, 0.5-1.8). There was no significant difference in adrenal suppression measured by overnight urinary cortisol/creatinine ratio (budesonide 5.2 ± 4.3, fluticasone 4.7 ± 3.1; 95% CI -2.2 to 1.2; P = 0.52) and urinary cortisol concentration (budesonide 51 53, fluticasone 43 31 [nmol/l]; 95% CI -35 to 20; P = 0.56). Conclusion: Inhaled budesonide and fluticasone have no significantly different effect on adrenal function in moderate to severe COPD. The adverse event profile of high-dose inhaled steroids should not influence the choice of medication.

Citation

Fahim, A., Faruqi, S., Wright, C. E., Kastelik, J. A., & Morice, A. H. (2012). Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease. Annals of Thoracic Medicine, 7(3), 140-144. https://doi.org/10.4103/1817-1737.98846

• Journal Article Type: Article
• Acceptance Date: Apr 2, 2012
• Online Publication Date: Jul 21, 2012
• Publication Date: Jul 1, 2012
• Deposit Date: May 23, 2022
• Publicly Available Date: Oct 27, 2022
• Journal: Annals of Thoracic Medicine
• Print ISSN: 1817-1737
• Electronic ISSN: 1998-3557
• Publisher: Medknow Publications
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 3
• Pages: 140-144
• DOI: https://doi.org/10.4103/1817-1737.98846
• Public URL: https://hull-repository.worktribe.com/output/3610227