Inhaled corticosteroid asthma treatment linked to adrenal su
Inhaled corticosteroids (ICS) have been instrumental in reducing asthma exacerbations and improving overall quality of life, although the risks that come with their use should be considered as well.

The Global Initiative for Asthma changed its guidelines in 2021 to recommend “as-needed” low-dose ICS use as a preferred relief option among adolescents and adults, the researchers used metabolomics — or the systematic analysis of small molecules in a biological sample — to study the effect of ICS use on asthma.

The examination of blood plasma from more than 14,000 individuals participating in four independent epidemiological studies yielded 973 steroid metabolites for analysis. According to the researchers, 17 of these metabolites were significantly reduced in individuals with prevalent asthma. These included reductions in DHEA-S and cortisol, which are primary hypothalamic-pituitary-adrenal axis steroid hormones that are biomarkers for adrenal suppression.

Steroid levels were reduced among all asthma cases regardless of medication use, although the largest reductions were associated with ICS use. These effects were dose-dependent, with significant reductions even at low doses.