Effects of ciclesonide and fluticasone on cortisol secretion in patients with persistent asthma.

[en] We compared the systemic and clinical effects of ciclesonide (CIC) and fluticasone propionate (FP) administered, in addition to CIC 160 microg x day(-1) and salmeterol 50 microg twice daily, in 32 patients with persistent asthma using a randomised double-blind, placebo-controlled, double-dummy, five-period crossover design. All patients exhibited a provocative concentration leading to a 20% decrease in forced expiratory volume in 1 s (PC(20)) methacholine <8 mg x mL(-1) and a PC(20) adenosine <60 mg x mL(-1). Primary outcome was 24-h serum cortisol suppression after 7 days. Secondary outcomes were changes in PC(20) methacholine and adenosine after 9 days. FP 500 microg x day(-1) and 1,000 microg x day(-1) significantly suppressed cortisol secretion versus placebo by -46.2 (95% confidence interval (CI) -83.8- -8.5) nmol x L(-1) and by -76.1 (95% CI -112.9- -39.3) nmol x L(-1), respectively. Neither dose of CIC (320 nor 640 microg x day(-1)) had a significant suppressive effect (-28.2 (95% CI -65.5-9.2) nmol x L(-1) and -37.3 (95% CI -74.7-0.0) nmol x L(-1), respectively). Differences between FP 1,000 microg x day(-1) and both CIC treatments were statistically significant (CIC 320 microg x day(-1): -48.0 (95% CI -84.8- -11.1) nmol x L(-1); CIC 640 microg x day(-1): -38.8 (95% CI -75.7- -1.9) nmol x L(-1)). Compared with placebo, the increase in PC(20) adenosine after the four treatments was small, but significant. Greater improvements in PC(20) adenosine were seen with FP 500 microg x day(-1) (1.8 (95% CI 1.0-2.6) doubling concentrations) compared with CIC 320 microg x day(-1) (0.9 (95% CI 0.1-1.7) doubling concentrations). No significant difference was seen between CIC 640 microg x day(-1) and FP 1,000 microg x day(-1). For a similar decrease in hyperresponsiveness, cortisol secretion was suppressed significantly with moderate-to-high doses of fluticasone propionate, but not with ciclesonide.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Derom, E.

Louis, Renaud ; Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie

Tiesler, C.

Engelstatter, R.

Kaufman, J.-M.

Joos, G. F.

Language :

English

Title :

Effects of ciclesonide and fluticasone on cortisol secretion in patients with persistent asthma.

Publication date :

2009

Journal title :

European Respiratory Journal

ISSN :

0903-1936

eISSN :

1399-3003

Publisher :

European Respiratory Society, Lausanne, Switzerland

Volume :

Issue :

Pages :

1277-86

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

http://erj.ersjournals.com/cgi/search?pubdate_year=2009&volume=&firstpage=&author1=Derom&author2=Louis&title=&andorexacttitle=and&titleabstract=&andorexacttitleabs=and&fulltext=&andorexactfulltext=and&fmonth=Jan&fyear=1988&tmonth=Aug&tyear=2009&fdatedef=1+January+1988&tdatedef=1+August+2009&flag=&RESULTFORMAT=1&hits=10&hitsbrief=25&sortspec=relevance&sortspecbrief=relevance&sendit=Search

Available on ORBi :

since 30 November 2009

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