| ORIGINAL ARTICLE |
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| Year : 2012 | Volume
: 7
| Issue : 3 | Page : 140-144 |
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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
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DOI: 10.4103/1817-1737.98846 
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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. |
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