Inhaled steroids suppress HPA axis

South African paediatric endocrinologists analysed the clinical features of hypothalamic-pituitary-adrenal axis suppression (HPAS) in 143 patients with asthma aged five to 18, finding 65.1% had some type of HPA dysfunction, 16.3% had HPAS and 32.3% had adrenal suppression.

Predictors of HPAS included nasal steroid use, low BMI and adherence to inhaled corticosteroids.

Dr Paul Robinson, staff specialist in the department of respiratory medicine at The Children’s Hospital at Westmead, Sydney, said it should be borne in mind that non-adherence was

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