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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
10
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pubmed:dateCreated |
2002-5-17
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pubmed:abstractText |
The goal of this study was to establish a reliable method to evaluate systemic bioavailability and to determine equisystemic effects (microgram dose producing equal systemic cortisol suppression) of inhaled corticosteroids (ICS). Steroid naive asthma subjects (n = 156) were enrolled at six centers. A 1-week doubling dose design was used for each of six ICS and matched placebos for a total of four doses. Systemic effect was evaluated by hourly plasma cortisol concentrations (8 P.M. to 8 A.M.), 12- and 24-hour urine cortisol concentrations, and a morning blood osteocalcin. The area under the concentration-time curve for hourly cortisol concentrations was the best outcome variable to assess systemic effect. For the six ICS and matching placebos (beclomethasone-chlorofluorocarbon [CFC], budesonide dry powder inhaler [DPI], fluticasone DPI, fluticasone-CFC metered dose inhaler [MDI], flunisolide-CFC, and triamcinolone-CFC), only the placebo group and fluticasone DPI did not demonstrate a significant dose-response effect. Thus microgram comparison of all ICS could only be performed at a 10% cortisol suppression: flunisolide-CFC - 936; triamcinolone-CFC - 787; beclomethasone-CFC - 548; fluticasone DPI - 445; budesonide DPI - 268; fluticasone-CFC MDI - 111. This study represents the first step in evaluation of ICS efficacy based on equisystemic (cortisol suppression) effects of a given ICS, rather than doses judged arbitrarily to be comparable on a microgram basis.
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pubmed:grant |
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pubmed:commentsCorrections |
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
AIM
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pubmed:chemical |
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pubmed:status |
MEDLINE
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pubmed:month |
May
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pubmed:issn |
1073-449X
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pubmed:author |
pubmed-author:BousheyHomer AHA,
pubmed-author:CherniackReuben MRM,
pubmed-author:ChinchilliVernon MVM,
pubmed-author:CraigTimothy JTJ,
pubmed-author:DolovichMyrnaM,
pubmed-author:DrazenJeffrey MJM,
pubmed-author:FaganJoanne KJK,
pubmed-author:FahyJohn VJV,
pubmed-author:FishJames EJE,
pubmed-author:FordJean GJG,
pubmed-author:IsraelElliottE,
pubmed-author:KraftMonicaM,
pubmed-author:KunselmanSusan JSJ,
pubmed-author:LazarusStephen CSC,
pubmed-author:LemanskeRobert FRFJr,
pubmed-author:MartinRichard JRJ,
pubmed-author:PetersStephen PSP,
pubmed-author:SorknessChristine ACA,
pubmed-author:SzeflerStanley JSJ
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pubmed:issnType |
Print
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pubmed:day |
15
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pubmed:volume |
165
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1377-83
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pubmed:dateRevised |
2007-11-14
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pubmed:meshHeading |
pubmed-meshheading:12016099-Administration, Inhalation,
pubmed-meshheading:12016099-Adrenal Cortex Hormones,
pubmed-meshheading:12016099-Adult,
pubmed-meshheading:12016099-Aged,
pubmed-meshheading:12016099-Androstadienes,
pubmed-meshheading:12016099-Asthma,
pubmed-meshheading:12016099-Beclomethasone,
pubmed-meshheading:12016099-Budesonide,
pubmed-meshheading:12016099-Dose-Response Relationship, Drug,
pubmed-meshheading:12016099-Drug Administration Schedule,
pubmed-meshheading:12016099-Female,
pubmed-meshheading:12016099-Fluocinolone Acetonide,
pubmed-meshheading:12016099-Follow-Up Studies,
pubmed-meshheading:12016099-Humans,
pubmed-meshheading:12016099-Hydrocortisone,
pubmed-meshheading:12016099-Male,
pubmed-meshheading:12016099-Middle Aged,
pubmed-meshheading:12016099-Probability,
pubmed-meshheading:12016099-Reference Values,
pubmed-meshheading:12016099-Single-Blind Method,
pubmed-meshheading:12016099-Treatment Outcome,
pubmed-meshheading:12016099-Triamcinolone
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pubmed:year |
2002
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pubmed:articleTitle |
Systemic effect comparisons of six inhaled corticosteroid preparations.
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pubmed:affiliation |
National Jewish Medical and Research Center, Denver, Colorado 80206, USA. martinr@njc.org
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.,
Randomized Controlled Trial,
Multicenter Study
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