[Adrenal effect of inhaled corticosteroids in adult asthmatic patients].

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.