Adachi Mitsuru, Minoguchi Kenji
First Department of Internal Medicine, Showa University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2006 Mar;44(3):151-9.
Inhaled corticosteroids (ICS) are usually well tolerated with smaller systemic effects than intravenous steroids, however, when the dose is high the likelihood of steroid-related systemic side effects like hypothalamic pituitary adrenal (HPA) axis suppression and osteoporosis are reported. We reviewed HPA axis suppression related to different ICS characteristics by affinity to steroid receptor and their pharmacokinetics, and also reviewed by randomized, controlled clinical trials. Within the approved dosages for each ICS in Japan, HPA axis suppression is basically minimal and clinically negligible.
吸入性糖皮质激素（ICS）通常耐受性良好，与静脉注射糖皮质激素相比，其全身效应较小。然而，据报道，当剂量较高时，会出现与糖皮质激素相关的全身副作用，如下丘脑-垂体-肾上腺（HPA）轴抑制和骨质疏松症。我们通过对类固醇受体的亲和力及其药代动力学，回顾了与不同ICS特征相关的HPA轴抑制情况，还通过随机对照临床试验进行了回顾。在日本批准的每种ICS剂量范围内，HPA轴抑制基本上最小，临床上可忽略不计。
