Mometasone furoate (MF) and fluticasone propionate (FP) are high potency inhaled corticosteroids. The systemic bioavailability of MF is claimed to be negligible, leading to a minimal potential for systemic adverse effects. We assessed the overnight urinary cortisol/creatinine as the primary outcome of adrenal suppression in 21 patients with persistent asthma (mean FEV1 = 91%). Patients were randomized in a crossover fashion to receive 2 weekly consecutive doubling incremental doses of either FP Accuhaler (500, 1,000, and 2,000 µg/day) or MF Twisthaler (400, 800, and 1,600 µg/day). For the 21 per protocol completed patients, there was significant suppression of overnight urinary cortisol/creatinine with high and medium doses of both drugs—as geometric mean fold suppression (95% confidence interval) from baseline: FP 2,000 µg, 1.85 (1.21–2.82, p = 0.002); FP 1,000 µg, 1.45 (1.07–1.96, p = 0.02); MF 1,600 µg, 1.92 (1.26–2.93, p = 0.001); and MF 800 µg, 1.39 (1.04–1.88, p = 0.02). For secondary outcomes of 8:00 A.M. plasma cortisol, serum osteocalcin, and early morning urinary cortisol/creatinine, there was significant suppression with MF and FP at the highest dose. Our data refute the assertion that MF has negligible systemic bioavailability and a lower potential for systemic adverse effects compared with FP.
|Number of pages||7|
|Journal||American Journal of Respiratory and Critical Care Medicine|
|Publication status||Published - Nov 2004|
- Adrenal suppression
- Asthma corticosteroids