Systemic bioactivity of inhaled fluticasone is not affected by the presence of emphysema

Jain, A.
June 2004
Thorax;Jun2004, Vol. 59 Issue 6, p482
Academic Journal
Inhaled corticosteroids reduce exacerbation frequency in COPD but it is not known whether the presence of emphysema, with decreased alveolar volume, results in impaired bioactivity. The systemic effects of fluticasone were compared in patients with COPD who did and did not have emphysema, respectively, both. The two groups had comparable airflow obstruction. The presence of emphysema was defined by carbon monoxide transfer factor <60% in conjunction with appropriate spirometric, clinical, and radiological findings. Systemic bioactivity was assessed using overnight 10 hour urinary cortisol excretion corrected for creatinine (OUCC) as a marker of adrenal suppression and serum osteocalcin as an indicator of bone metabolism. OUCC and osteocalcin were measured at baseline and after 2 weeks of fluticasone.


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