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ICS, nasal steroid may influence HPAS dysfunction
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Adhering to inhaled corticosteroids and nasal steroids predicted hypothalamic-pituitary-adrenal axis suppression, according to study findings published online.
F. Stephen Hough, MBChB, FCP, MMed, MD, of the endocrine unit in the department of medicine at Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa, and colleagues published data on 143 children aged 5 to 18 years who were recruited during a 2-year period from three allergy units.
Hypothalamic-pituitary-adrenal axis suppression (HPAS) dysfunction was reported in 65.1% of the study cohort. The researchers also said adrenal suppression was seen in 32.3% of the patients, hypothalamic-pituitary suppression in 22.2% and hypocortisolemia in 6.1%.
Log daily nasal steroid was linked to HPAS in the logistic regression model (OR=3.7; 95% CI, 1.1–13.6), and daily inhaled corticosteroids (ICS) plus nasal steroid dose per meter squared predicted HPAS in the univariate logistic regression model (P=.038).
Hough and colleagues reported a link between higher BMI levels and poor adherence to ICS and protection against HPAS.
“We, therefore, recommend that every asthmatic child with a low BMI, who is treated with both ICS and nasal steroids, and is adherent to therapy, should have his or her HPA function assessed,” the researchers said.
They also recommended further trials to determine what genetic factors may protect or put children at risk for HPAS.
Disclosure: The researchers report no relevant financial disclosures.
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