Recovery of Adrenal Function after Substitution of Beclomethasone Dipropionate for Oral Corticosteroids

Abstract

Whatever the reason for this excess of chronic bronchitis among the "droopers"-more prolonged and concentrated tobacco smoke exposure or differing proportions of "sidestream" and "mainstream" smoke-there seems little doubt that it is a dangerous method of smoking cigarettes involving greater risk of developing chronic bronchitis and, on the evidence of Brett and Benjamin (1968), of increased mortality from lung cancer than is the normal method.I wish to thank Professor M. R. Alderson, formerly Director of the Regional Cancer Registration Bureau, who helped plan the investigation, and the Manchester Regional Hospital Board who allowed the staff of the Ma.f Radiography Service to obtain the histories and the computer section to process the information. I am particularly grateful for the care and attention to detail given by the staffs of these departments.

Adrenocortical responsiveness after discontinuous corticosteroid therapy

“…The mean resting plasma cortisol levels differed significantly in the three groups" 1.5+_0.8gg/ 100 ml in the group o f patients on daily steroids, 11.1 _+ 3.3 ~tg/100 ml in patients off steroids every fourth day, and 17.8 + 3.0 gg/100 ml in the control subjects (Table 2 and 3).…”

“…In the majority of cases, these steroids are used as anti-inflammatory and immunosuppressive agents [2,9]. Their efficacy is well established in many immunopathological conditions, but the extent of side reactions, for example suppression of the HPA, seriously limits their use.Abbreviations: AIHA = autoimmune hemolytic anemia; F = fluocortolone; HPA = hypothalamo-pituitary-adrenal axis; MS =multiple sclerosis; P=prednisone; PRCA=pure red cell anemia; SLE = systemic lupus erythematosusThe degree of HPA suppression depends on the type and dosage of glucocorticosteroids, route and frequency of administration and duration of treatment [11,13,16]. Daily administration of 15 mg or more of prednisone for at least 1 month suppresses adrenal function [18].…”

Substitution of Beclomethasone Aerosol for Oral Prednisolone in the Treatment of Chronic Asthma

“…The negligible reduction in the maintenance dose of prednisolone in the control group indicates that the patients who participated in the trial were not receiving unnecessarily high maintenance doses of this drug. A control group was not included in previously reported beclomethasone trials of a similar nature (Brown et al, 1972;Maberly et al, 1973), and our main objection to these studies is that some of the reductions in the maintenance dose of prednisolone may have been achieved only because the initial dose was in excess of the patient's requirements. All patients on withdrawal from this trial were treated with known beclomethasone if it had not been possible to replace prednisolone by beclomethasone.…”

Beclomethasone dipropionate aerosol in long‐term treatment of perennial and seasonal asthma in children and adults: a report of five‐and‐half years' experience in 600 asthmatic patients.

“…It must be emphasized that, with the exception of patients who are able to stop treatment with BDA without relapse, this method of treatment is still only a means of suppressing the allergic reaction without disturbing pituitary-adrenal function (Harris et al, 1973;Buisseret, 1973;Maberly et al, 1973). Although its proper use may enable many patients to lead a normal life for the first time in many years, such results should not obscure the fact that the cause or causes of the asthma are still present and often unidentified.…”