Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Asthma guidelines recommend the use of inhaled glucocorticoids (GCS). However, high doses increase the risk of systemic effects including suppression of the hypothalamic-pituitary-adrenal (HPA) axis by negative feedback, reduction of bone mass, inhibition of growth in children and skin thinning. Plasma concentration depends on the dose delivered from the inhaler, the distribution of delivery (ratio of lung to gut), and the degree of first-pass metabolism. Improving lung delivery increases lung absorption and reduces gut absorption and, depending on the extent of first-pass metabolism, may have significant effects on the systemic drug load. Qvar (3M Pharmaceuticals' hydrofluoroalkane beclomethasone dipropionate (HFA-BDP)), which produces an extra fine aerosol, improves lung delivery without producing clinically significant HPA suppression within the recommended dose range. Within this range Qvar produces no more HPA suppression than an equal dose of CFC-BDP and, in addition, lower doses of Qvar are effective in asthma control.
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PMID:Steroid safety: the endocrinologist's view. 1034 32

Asthma is a complex disease of the respiratory tract associated with chronic inflammation in which an intricate network of cells and cellular factors plays a major role. Asthma is one of the most common chronic diseases, with an estimated 300 million cases worldwide, imposing a considerable burden on society in morbidity, quality of life, and healthcare costs. Inhaled corticosteroids (ICSs) form the gold standard, first-line therapy in the effective management of persistent asthma and reduce morbidity and mortality from asthma. However, long-term use of high-dose ICS therapy has potential to cause systemic side effects-impaired growth in children, decreased bone mineral density, skin thinning and bruising, and cataracts. Hypothalamic-pituitary-adrenal-axis suppression, measured by serum or urine cortisol decrease, correlates with the occurrence of systemic side effects of high-dose ICSs. Therefore, cortisol may be a relevant surrogate marker to identify the potential for adverse effects from ICS therapy. Ciclesonide is a new generation ICS with demonstrable safety and efficacy in the treatment of asthma. The unique pharmacologic characteristics of ciclesonide, such as reduced local adverse effects, lack of cortisol suppression, and the option for once-daily dosing, may improve compliance with therapy and allow long-term use of ICSs without fear of systemic adverse effects.
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PMID:Systemic side effects of inhaled corticosteroids in patients with asthma. 1641 23