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Wilson, Andrew M., Sims, Erika J. 
ORCID: https://orcid.org/0000-0002-7898-0331 and Lipworth, Brian J.
(1999)
Dose response with fluticasasone propionate on adrenocortical activity and recovery of basal and stimulated responses after stopping treatment.
Cleveland Clinic Journal of Medicine, 50 (3).
pp. 329-335.
Abstract
OBJECTIVE: To evaluate the dose–response relationship for adrenocortical activity with fluticasone propionate (FP) and to assess basal and dynamic markers after stopping treatment for 3 days. PATIENTS AND DESIGN: Fourteen asthmatic patients were recruited: mean age 33.3 years, forced expiratory volume in 1s (FEV1): 91.3% predicted, forced mid expiratory flow rate (FEF25–75): 58.1% predicted. A single blind study design was used comparing a placebo run-in with sequentially low, medium and high doses of FP and a placebo washout. All active treatments, placebo and washout were each for 3 days. FP was given at steady-state with twice daily divided dosing at 0800h and 2200h at doses of 375μg, 875μg, and 1750μg per day. MEASUREMENTS: A 100 μg iv bolus hCRF test was performed at 0800h after the run-in and washout periods. Blood samples were taken for 0800h serum cortisol and osteocalcin as well as an overnight 10h urine collection for cortisol/creatinine excretion after the run-in period, each dose of active treatment and washout. RESULTS: For serum cortisol (pre and post hCRF stimulation) there was no significant difference between placebo and washout values. Mean (SE) cortisol (nmol/1) values pre hCRF were run-in: 644.5 (59.7), washout: 550.3 (42.8) and post hCRF were run-in: 690.9 (42.9), washout: 719.1 (43.8). There was a significant (P < 0.05) difference between run-in vs medium and high doses for 0800h serum cortisol, overnight urinary cortisol and overnight urinary cortisol/creatinine excretion; and vs high dose for serum osteocalcin. The fold difference (95% CI for difference) between run-in and high dose was: 2.2 (1.5–3.2) for overnight urinary cortisol, 2.5 (1.5–4.1) for overnight urinary cortisol/creatinine, 2.0 (1.1–3.6) for serum cortisol, and 1.2 (1.1–1.3) for serum osteocalcin. CONCLUSION: Fluticasone propionate exhibited dose related adrenal suppression with treatment. The suppressive effects of fluticasone propionate on adrenocortical activity were greater than those observed on osteocalcin.
| Item Type: | Article |
|---|---|
| Additional Information: | Source:RK Note: |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) |
| Depositing User: | EPrints Services |
| Date Deposited: | 25 Nov 2010 11:12 |
| Last Modified: | 17 Jun 2024 13:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/14697 |
| DOI: | 10.1046/j.1365-2265.1999.00652.x |
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