Annals of Thoracic Medicine
ORIGINAL ARTICLE
Year
: 2012  |  Volume : 7  |  Issue : 3  |  Page : 140--144

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


Ahmed Fahim, Shoaib Faruqi, Caroline E Wright, Jack A Kastelik, Alyn H Morice 
 Division of Cardiovascular and Respiratory Studies, Department of Respiratory Medicine,Castle Hill Hospital, Cottingham, HU16 5JQ, United Kingdom

Correspondence Address:
Ahmed Fahim
Clinical Research Fellow, Division of Cardiovascular and Respiratory Studies, Department of Respiratory Medicine, Castle Hill Hospital, Castle Road, Cottingham, HU165JQ
United Kingdom

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.


How to cite this article:
Fahim A, Faruqi S, Wright CE, Kastelik JA, Morice AH. Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease.Ann Thorac Med 2012;7:140-144


How to cite this URL:
Fahim A, Faruqi S, Wright CE, Kastelik JA, Morice AH. Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease. Ann Thorac Med [serial online] 2012 [cited 2020 Jun 5 ];7:140-144
Available from: http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2012;volume=7;issue=3;spage=140;epage=144;aulast=Fahim;type=0