Background: In our study, we aimed to compare the potential for systemic side effects of two most frequently preferred inhaled corticosteroids (CS) in the treatment of asthma, Fluticasone Propionate (FP) and Budesonide (B), by evaluating morning plasma cortisol levels.
Materials and method: The study Included 69 moderate-persistent and severe asthmatic patients using minimal 1000 mcg/day FP (n=33) or B (n=36) for at least 6 months. The mean age of the patients was 49.2±15.2 years in the f* group using FP, and was 48.1 ±12.2 years (p>0.0S) in the 2ld group using B. Patients were not utilizing any systemic drugs for the last 20 days and their morning plasma cortisol level measurements were performed between 08.00 and 09.00 a.m.
Results: Mean plasma cortisol level of the f group was 10.3±4.6 mcg/dl and that of the 2ld group was 10.4±5.4 mcg/dl (pX>.05). Mean plasma cordsol level of the age matched healthy hospital persone/i was 16.0±5.3 mcg/di and the mean cortisol level of the 1st group was significantly lower than the control group (pO.Ol). Four patients (12.1%) in the 1st group and six patients (16.7%) in the 2™* group had extremely low plasma cortisol levels, but such low levels were not measured in the control group at all.
Conclusion: We could not define any difference between asthmatic patient groups utilising FP and B regarding their potentials for systemic side effects (p>0.05); on the other hand 12.1 % of the patients utilising FP and 16.7 % of the patients utilising B had extremely low plasma levels of cortisol, which could lead to clinically important outcomes. We think that early morning plasma cortisol levels should be measured at certain intervals in patients utilising high dose of inhaled CS to detect the patients vulnerable to systemic side effects.
Key words: Asthma, systemic side effects, fluticasone propionate, budesonide.
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