Todd G, Dunlop K, McNaboe J, Ryan M F, Carson D, Shields M D
Antrim Hospital, UK.
Lancet. 1996 Jul 6;348(9019):27-9. doi: 10.1016/s0140-6736(96)03339-9.
Fluticasone propionate was introduced in 1993 in the UK as a potentially safer inhaled corticosteroid than those already in use. The efficacy and safety of fluticasone has been established at recommended doses of 200 micrograms/day, but not at higher doses that are often used.
Growth retardation was observed in six severely asthmatic children after introduction of high-dose fluticasone propionate treatment (dry powder). Assessment of cortisol response was by insulin-induced hypoglycaemia in three cases, by short tetracosactrin test in two, and by low-dose tetracosactrin and 24-hour urinary cortisol/creatinine ratio in one.
Six children with growth retardation noted after treatment with high-dose fluticasone propionate were found to have adrenal suppression. In one case the growth rate and cortisol response returned to normal 9 months after the fluticasone dose was reduced to 500 micrograms/day.
When high doses of fluticasone propionate are used, growth may be retarded and adrenal suppression may occur.
1993年，丙酸氟替卡松在英国上市，被认为是一种比已在使用的吸入性皮质类固醇更安全的药物。丙酸氟替卡松在推荐剂量200微克/天的疗效和安全性已得到确立，但在常用的更高剂量下尚未得到验证。
在6名重度哮喘儿童接受高剂量丙酸氟替卡松（干粉）治疗后观察到生长发育迟缓。3例通过胰岛素诱发低血糖评估皮质醇反应，2例通过短程二十四肽促皮质素试验评估，1例通过低剂量二十四肽促皮质素和24小时尿皮质醇/肌酐比值评估。
6名在接受高剂量丙酸氟替卡松治疗后出现生长发育迟缓的儿童被发现存在肾上腺抑制。1例在丙酸氟替卡松剂量降至500微克/天后9个月，生长速率和皮质醇反应恢复正常。
使用高剂量丙酸氟替卡松时，可能会出现生长发育迟缓以及肾上腺抑制。
