Effect of therapeutic doses of mometasone furoate on cortisol levels in children
with mild asthma.
Author(s): Skoner DP, Gentile DA, Angelini B.
Affiliation(s): Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA.
dskoner@wpahs.org
Publication date & source: 2010, Allergy Asthma Proc. , 31(1):10-9
Corticosteroids are the foundation of pharmacologic treatment for children with
asthma. However, high-dose inhaled corticosteroid treatment can cause
hypothalamic-pituitary-adrenal (HPA) axis suppression. We investigated the effect
of three doses of mometasone furoate administered via dry-powder inhaler (MF-DPI)
on the HPA axis in children. Fifty children (6-11 years) with mild asthma of > or
=6 months' duration were randomized to MF-DPI, 100 (n = 13), 200 (n = 13), or 400
micrograms b.i.d. (n = 12), or placebo (n = 12) for 29 days. The primary end
point was change from baseline in the 12-hour area under the
plasma-cortisol-concentration-time curve (AUC). Secondary parameters included
plasma cortisol response to cosyntropin stimulation and 24-hour urinary free
cortisol concentrations. Compared with placebo, AUC changes associated with
treatments of MF-DPI, 100 or 200 micrograms b.i.d., were not significant, whereas
a significant change was observed with MF-DPI, 400 micrograms b.i.d. (27%; p =
0.05). Responses to cosyntropin stimulation and urinary cortisol measurements
were similar to placebo with all MF-DPI doses. All regimens were well tolerated.
MF-DPI did not have a significant effect on plasma or urinary cortisol levels at
doses up to 200 micrograms b.i.d. in children with mild asthma. Higher MF-DPI
doses may potentially suppress the HPA axis.
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