Effects of long term inhaled high dose beclomethasone dipropionate on adrenal function.

Smith, Michael J.; Hodson, M E

doi:10.1136/thx.38.9.676

Cited by 148 publications

(45 citation statements)

References 10 publications

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“…The effect appears to be more marked with BDP than with BUD. [78][79][80][81][82] Doseranging studies in adults and children indicate that single doses of FP exhibit three-fold greater adrenal suppression than BUD, on a microgram equivalent basis. 83 One RCT compared the effects of FP 1500 µg/day and BUD 1600 µg/day with placebo in both healthy participants and participants with moderately severe asthma over a 7-day duration.…”

mentioning

confidence: 99%

“…78,79 Although these biochemical changes are unequivocal, their clinical importance remains unclear, and even at high doses of ICS there remains significant inter-individual variability, with many patients demonstrating little or no evidence of adrenal suppression. 78,79 One of the major concerns of long-term ICS use is the potential for AEs on bone turnover, resulting in an increased risk for osteoporosis and fracture. This is mediated through the inhibition of osteoblast function (bone formation) and by increasing osteoclast function (leading to increased bone resorption).…”

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confidence: 99%

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Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in adults and children aged 12 years and over

Shepherd¹,

Rogers²,

Anderson³

et al. 2008

Health Technol Assess

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as royal colleges and NHS trusts. These sugges...

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mentioning

confidence: 99%

mentioning

confidence: 99%

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in adults and children aged 12 years and over

Shepherd¹,

Rogers²,

Anderson³

et al. 2008

Health Technol Assess

View full text Add to dashboard Cite

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“…92,93 The effect of ICS on growth in children has been a controversial issue. A number of short-term studies using knemometry (measurement of lower limb length using highly accurate measures) have demonstrated that high-dose ICS use is associated with short-term growth suppression.…”

Section: Adverse Eventsmentioning

confidence: 99%

“…The effect appears to be more marked with BDP than with BUD. [92][93][94][95][96] Doseranging studies in adults and children indicate that single doses of FP exhibit three-fold greater adrenal suppression than BUD, on a microgram equivalent basis. 97 One randomised controlled trial (RCT) compared the effects of FP 1500 µg/day and BUD 1600 µg/day with placebo in both healthy participants and participants with moderately severe asthma over 7 days.…”

Section: Adverse Eventsmentioning

confidence: 99%

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in children under the age of 12 years

Main¹,

Shepherd²,

Anderson³

et al. 2008

Health Technol Assess

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email.Paying by official purchase order You can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA Health Technology Assessment is indexed and abstracted in Index Medicus/MEDLINE, Excerpta Medica/EMBASE and Science Citation Index Expanded (SciSearch ® ) and Current Contents® /Clinical Medicine. NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as royal colleges and NHS trusts. These suggestions are carefully prioritised by panels of independent experts (including NHS se...

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“…In these early studies, inhaled corticosteroids proved to be safe as far as the suppressive effects on the suprarenal function are concerned, even when administered at high doses [3]. The evaluation of adrenal function was made by using plasma cortisol levels, a method with a poor sensitivity.…”

mentioning

confidence: 99%

Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study

Luengo

Río²,

Pons³

et al. 1997

Eur Respir J

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Recent studies suggest that inhaled corticosteroids can adversely affect bone metabolism. The objective of this study was to evaluate the importance of these adverse effects in a case-control study.Bone mineral density (BMD) was measured in 48 asthmatic adults (15 males and 33 females) treated with inhaled steroids (beclomethasone or budesonide) and in 48 gender and age-matched healthy subjects at baseline and at 2 yrs. Vertebral BMD was measured by dual energy X-ray densitometry.Patients had been treated with a dose of 662±278 µg (range 300-1,000 µg) of beclomethasone dipropionate or budesonide for more than 1 yr (mean duration of treatment 10.6 yrs, range 1-16 yrs). Twenty four patients had needed 1-6 short courses of oral steroids and seven had received oral corticosteroids (mean daily dose 6.2 mg prednisone) for 2-15 yrs more than 4 yrs prior to the BMD measurements. During the follow-up, 14 patients required 1-3 short courses of oral steroids. There was no correlation either between inhaled corticosteroid doses or duration of treatment and BMD values. There were no significant differences in BMD baseline values between patients and healthy controls. BMD significantly decreased in both groups at 2 yrs, from 1.08±0.19 to 1.05±0.19 g·cm -2 (p=0.002) in asthmatics versus 1.12±0.17 to 1.09±0.18 g·cm -2 (p=0.008) in controls. There were no significant differences in BMD loss between patients and healthy controls. Furthermore, no differences were found in bone loss when pre-and postmenopausal women were compared with their healthy control counterparts. No differences in baseline BMD were found between patients who had received regular oral corticosteroid therapy or booster courses of oral corticosteroids and those who had not.Inhaled corticosteroid treatment at a mean dose of 662 µg·day -1 and sporadic booster courses of oral corticosteroids do not further increase bone mass loss with respect to that expected from natural bone mass loss.

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Effects of long term inhaled high dose beclomethasone dipropionate on adrenal function.

Cited by 148 publications

References 10 publications

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in adults and children aged 12 years and over

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in adults and children aged 12 years and over

Systematic review and economic analysis of the comparative effectiveness of different inhaled corticosteroids and their usage with long-acting beta2 agonists for the treatment of chronic asthma in children under the age of 12 years

Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study

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