The largest metabolomic study of asthma thus far, comprising >14,000 people from four independent cohorts, has found that inhaled corticosteroid (ICS) treatment is associated with adrenal suppression, even at low doses. Thus, ICS dosage should be optimized to minimize adrenal suppression while maintaining its established benefits in asthma management.
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References
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf (2021). This report summarizes the recommended changes in asthma treatment guidelines, including suggestions for increased use of low-dose ICSs.
Lapi, F. et al. The use of inhaled corticosteroids and the risk of adrenal insufficiency. Eur. Respir. J. 42, 79–86 (2013). This review article is on ICSs and the risk of adrenal insufficiency in asthma.
The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N. Engl. J. Med. 343, 1054–1063 (2000). This paper reports the results from a four-year RCT of ICS treatment.
Hawcutt, D. B. et al. Susceptibility to corticosteroid-induced adrenal suppression: a genome-wide association study. Lancet Respir. Med. 6, 442–450 (2018). This study is the largest genome-wide association study so far of ICS-induced adrenal suppression.
Pietzner, M. et al. Plasma metabolites to profile pathways in noncommunicable disease multimorbidity. Nat Med. 27, 471–479 (2021). This paper is a summary of the EPIC-Norfolk cohort and metabolomics data.
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This is a summary of: Kachroo, P. et al. Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma. Nat. Med. https://doi.org/10.1038/s41591-022-01714-5 (2021).
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Inhaled corticosteroid use for asthma is linked to adrenal suppression. Nat Med 28, 645–646 (2022). https://doi.org/10.1038/s41591-022-01732-3
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DOI: https://doi.org/10.1038/s41591-022-01732-3
