ArticlePaediatrics & child health2012
Prevalence of hypothalamic-pituitary-adrenal axis suppression in children treated for asthma with inhaled corticosteroid.
Article in Paediatrics & child health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review: adrenal insufficiency secondary to swallowed topical corticosteroids in eosinophilic oesophagitis.Alimentary pharmacology & therapeutics · 2018Pooled it
- The Causal Relationship Between Asthma and Hippocampal Volume: A Study Based on Bidirectional Mendelian Randomization Analysis.Brain and behavior · 2025Article
- A Report of 3 Cases of Adrenal Suppression Due to Glucocorticoid Hypersensitivity to Inhaled Corticosteroids.JCEM case reports · 2025Article
- Montelukast Use and the Risk of Neuropsychiatric Adverse Events in Children.JAMA pediatrics · 2025Article
- Effect of Long-term Inhaled Corticosteroids on the Hypothalamic-Pituitary-Adrenal Axis in Children with Asthma.Indian journal of pediatrics · 2024Article
- Hypothalamic-Pituitary-Adrenal Axis Suppression with Inhaled Corticosteroids-Time to Close the Debate?Indian journal of pediatrics · 2024Article
- Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma.Nature medicine · 2022Article
- Halobetasol propionate lotion 0.05% in patients 12 to 16 years 11 months of age with plaque psoriasis: Results of an open-label study evaluating adrenal suppression potential.JAAD international · 2022Article
- Adrenal suppression from exogenous glucocorticoids: Recognizing risk factors and preventing morbidity.Paediatrics & child health · 2021Review
- Review
- A randomized, double-blind, placebo-controlled, parallel-group study of once-daily inhaled fluticasone furoate on the hypothalamic-pituitary-adrenocortical axis of children with asthma.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2020Article
- Adrenal insufficiency from steroid-containing complementary therapy: importance of detailed historyEndocrinology, diabetes & metabolism case reports · 2019Article
- Adrenal suppression from glucocorticoids: preventing an iatrogenic cause of morbidity and mortality in children.BMJ paediatrics open · 2019Review
- Asthma and Medicines - Long-Term Side-Effects, Monitoring and Dose Titration.Indian journal of pediatrics · 2018Review
- Long-Term Cortisol Concentration in Scalp Hair of Asthmatic Children Using Inhaled Corticosteroids: A Case-Control Study.Hormone research in paediatrics · 2017Article
- The use of inhaled corticosteroids in pediatric asthma: update.The World Allergy Organization journal · 2016Review
- Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol.European journal of endocrinology · 2015Article
- Evidence of hypothalamic-pituitary-adrenal axis suppression during moderate-to-high-dose inhaled corticosteroid use.European journal of pediatrics · 2015Article
- CSACI position statement: systemic effect of inhaled corticosteroids on adrenal suppression in the management of pediatric asthma.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2015Article
- Inhaled corticosteroids and secondary adrenal insufficiency.The open respiratory medicine journal · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the prevalence of hypothalamic-pituitary-adrenal (HPA) axis suppression in asthmatic children on inhaled corticosteroids (ICS).
methodsClinical and demographic variables were recorded on preconstructed, standardized forms. HPA axis suppression was measured by morning serum cortisol levels and confirmed by low-dose adrenocorticotropic hormone stimulation testing.
resultsIn total, 214 children participated. Twenty children (9.3%, 95% CI 5.3% to 13.4%) had HPA axis suppression. Odds of HPA axis suppression increased with ICS dose (OR 1.005, 95% CI 1.003 to 1.009, P<0.001). All children with HPA axis suppression were on a medium or lower dose of ICS for their age (200 μg/day to 500 μg/day). HPA axis suppression was not predicted by drug type, dose duration, concomitant use of long-acting beta-agonist or nasal steroid, or clinical features.
conclusionLaboratory evidence of HPA axis suppression exists in children taking ICS for asthma. Children should be regularly screened for the presence of HPA axis suppression when treated with high-dose ICS (>500 μg/day). Consideration should be given to screening children on medium-dose ICS.
Indexed as
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.