Hypothalamic-pituitary-adrenal axis; Category

ICS are the best first-line medication for the management of non-intermittent asthma in children. However, as found in the present study, a significant number of children being treated for asthma with ICS have HPA axis suppression and are, therefore, at risk of adrenal crisis. Importantly, all children in the present study were on what is […]

Every effort should be made to reduce the dose of ICS to the lowest effective dose that can achieve asthma symptom control. The use of a combined long-acting beta-agonist with ICS was not associated with the occurrence of HPA axis suppression in the present study, and it is possible that a lower effective dose could […]

After the study began, a small (n=26) pilot study identified morning serum ACTH testing as a potential screening test for HPA axis suppression. However, ACTH has a short half-life that requires a strict protocol for testing. The authors concede that it would only be useful at large centres with onsite facilities familiar with the sampling […]

A review of the literature identified a single published study that measured the prevalence of HPA axis suppression in children being treated with ICS . Nine of 26 children (35%) were found to have suppression as identified by gold standard metyra-pone testing. Unlike the current study, only the use of budesonide was studied and no […]

We identified a significant prevalence of HPA axis suppression in children taking ICS for treatment of asthma (9.3%) — buy asthma inhaler. In all cases, children were receiving medium doses or less of ICS (range: 200 pg/day to 500 pg/day fluticasone or equivalent). Additionally, daily ICS dose was predictive of HPA axis suppression, with a […]

All children with HPA axis suppression were on a medium or lower dose of ICS for their age. A statistically significant higher daily dose of ICS was found in children with HPA axis suppression compared with children with a normal HPA axis (median difference 250 pg/day, P<0.001). Fischer’s exact test did not reveal any other […]

A total of 43 patients (20.0%) had low morning serum cortisol levels and were required to attend for low-dose inpatient ACTH stimulation testing. One patient had an ACTH stimulation test despite having a normal morning cortisol level (178 nmol/L) and did not have evidence of suppression. A total of 20 children (9.3%, 95% CI 5.3% […]