ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2011
Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy.
Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- The use of corticosteroids in the lateral sinus augmentation surgical procedure: A systematic review and meta-analysis.Clinical implant dentistry and related research · 2022Pooled it
- Randomized Cross-Over Study of In-Vehicle Cabin Air Filtration, Air Pollution Exposure, and Acute Changes to Heart Rate Variability, Saliva Cortisol, and Cognitive Function.Environmental science & technology · 2023Trial
- Transient adrenal insufficiency in diffuse large B cell lymphoma patients after chemotherapy with short-course, high-dose corticosteroids.Annals of hematology · 2018Trial
- Inhaled fluticasone furoate/vilanterol does not affect hypothalamic-pituitary-adrenal axis function in adolescent and adult asthma: randomised, double-blind, placebo-controlled study.The clinical respiratory journal · 2013Trial
- Prevalence, risk factors, and the screening value of basal cortisol for adrenal insufficiency after corticosteroid therapy in children with idiopathic nephrotic syndrome.Clinical and experimental nephrology · 2026Article
- Adrenal suppression secondary to inhaled corticosteroids.Paediatrics & child health · 2026Article
- Neonatologists' practices in screening and managing corticosteroid-induced adrenal insufficiency in the NICU- a multicenter study.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Salivary Cortisol versus Serum Cortisol Levels in Asthmatic Children Treated with Inhaled Corticosteroid Alone or in Combination with Montelukast.Journal of asthma and allergy · 2026Article
- Sarcoidosis in the Genomic Era: From Genetic Drivers to Tailored Therapies.Current allergy and asthma reports · 2025Review
- Glucocorticoid treatment and adrenal suppression in children: current view and open issues.Journal of endocrinological investigation · 2025Review
- Dangers of under-treatment and over-treatment with inhaled corticosteroids in children with asthma.Pediatric pulmonology · 2025Article
- Inhaled corticosteroid increased the risk of adrenal insufficiency in patients with chronic airway diseases: a nationwide population-based study.Scientific reports · 2024Observational
- Urine metabolomics signature reveals novel determinants of adrenal suppression in children taking inhaled corticosteroids to control asthma symptoms.Immunity, inflammation and disease · 2024Article
- Clinical Pharmacology in Sarcoidosis: How to Use and Monitor Sarcoidosis Medications.Journal of clinical medicine · 2024Review
- Navigating the Landscape of Hydrocortisone Administration in Septic Shock: Current Concepts and Future Directions.Cureus · 2023Review
- Long-Term Usage of Oral Glucocorticoids Leading to Adrenal Insufficiency: A Comprehensive Review of the Literature.Cureus · 2023Review
- Current Screening Strategies for the Diagnosis of Adrenal Insufficiency in Children.Pediatric health, medicine and therapeutics · 2023Review
- Effect of Oral Prednisolone after Collagenase Injection for Dupuytren's Contracture: A Randomized, Controlled Trial with a 1-Year Follow-Up.Journal of hand and microsurgery · 2022Article
- Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma.Nature medicine · 2022Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inhaled corticosteroids (ICSs) are the most effective anti-inflammatory agents available for the treatment of asthma and represent the mainstay of therapy for most patients with the disease. Although these medications are considered safe at low-to-moderate doses, safety concerns with prolonged use of high ICS doses remain; among these concerns is the risk of adrenal suppression (AS). AS is a condition characterized by the inability to produce adequate amounts of the glucocorticoid, cortisol, which is critical during periods of physiological stress. It is a proven, yet under-recognized, complication of most forms of glucocorticoid therapy that can persist for up to 1 year after cessation of corticosteroid treatment. If left unnoticed, AS can lead to significant morbidity and even mortality. More than 60 recent cases of AS have been described in the literature and almost all cases have involved children being treated with ≥500 μg/day of fluticasone.The risk for AS can be minimized through increased awareness and early recognition of at-risk patients, regular patient follow-up to ensure that the lowest effective ICS doses are being utilized to control asthma symptoms, and by choosing an ICS medication with minimal adrenal effects. Screening for AS should be considered in any child with symptoms of AS, children using high ICS doses, or those with a history of prolonged oral corticosteroid use. Cases of AS should be managed in consultation with a pediatric endocrinologist whenever possible. In patients with proven AS, stress steroid dosing during times of illness or surgery is needed to simulate the protective endogenous elevations in cortisol levels that occur with physiological stress.This article provides an overview of current literature on AS as well as practical recommendations for the prevention, screening and management of this serious complication of ICS therapy.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.