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Corticosteroid Use Associated with Adrenal Insufficiency

Risk is dose-related with either oral or inhaled corticosteroids

FRIDAY, May 5 (HealthDay News) -- Patients taking oral or inhaled corticosteroids are at a dose-related increased risk of developing adrenal insufficiency, according to a study in the May issue of Thorax.

Kevin J. Mortimer, and colleagues from Nottingham University in the United Kingdom, examined the association between adrenal insufficiency and corticosteroid exposure in the general population through a database of computerized general practice data on 2.4 million people. The analysis identified 154 cases of adrenal insufficiency and 870 matched controls.

The researchers found a dose-related increased risk of adrenal insufficiency with use of oral corticosteroids (odds ratio 2.0 per course of treatment per year). There was also a dose-related increase in risk with inhaled corticosteroids in the 90 days before diagnosis (odds ratio 3.4). After adjusting for oral corticosteroid exposure, the risk remained dose-related although the odds ratio was reduced to 1.6.

"People prescribed an oral or inhaled corticosteroid are at a dose-related increased risk of adrenal insufficiency although the absolute risk is small," Mortimer and colleagues conclude. "This analysis suggests that the increased risk in people prescribed an inhaled corticosteroid is largely due to oral corticosteroid exposure, but inhaled corticosteroids may have an effect when they are taken at higher doses."

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