Assessment of systemic corticosteroid activity.

The potency of the inhaled corticosteroid, dose, duration of treatment, and the study subject receiving treatment all play a role in the effects observed on the HPA axis. At low/medium doses of inhaled corticosteroids, where there is minimal/modest HPA axis suppression, there should be no risk of adrenal crisis even under stressful conditions (6). Thus, the risk of acute adrenal insufficiency, culminating in adrenal crisis, in patients taking inhaled steroids is extremely unlikely.