European Journal of Clinical Pharmacology

, Volume 40, Issue 1, pp 77–82

Assessment of systemic effects of inhaled glucocorticosteroids: comparison of the effects of inhaled budesonide and oral prednisolone on adrenal function and markers of bone turnover

  • B. H. Jennings
  • K. -E. Andersson
  • S.Å. Johansson


The effects of inhaled budesonide (BUD) and oral prednisolone (PRED) on markers of bone turnover and adrenal function were compared in a randomized, double-blind, double-dummy, crossover study. Twelve healthy subjects were treated for one week with 0.8, 1.6 and 3.2 mg/day BUD and 5, 10 and 20 mg/day PRED, the three doses being given in ascending order. Plasma cortisol and adrenal cortical androgens showed a significantly decreasing trend with the increasing doses of both drugs, although PRED caused a significantly greater decrease than BUD. Osteoblast function, reflected by serum osteocalcin and alkaline phosphatase was significantly reduced by PRED, but BUD had a significantly different effect as it affected only osteocalcin. Urinary hydroxyproline/creatinine, a marker of bone resorption, was not changed by either drug. The average potency ratio for equivalent systemic effects was PRED:BUD 3.9:1. During short-term treatment at equivalent anti-asthmatic doses, BUD has significantly less effect on adrenal function and bone turnover than PRED, and it may carry less risk of bone complications during long-term treatment.

Key words

Glucocorticosteroids cortisol androgens osteocalcin alkaline phosphatase hydroxyproline budesonide prednisolone healthy volunteers 


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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • B. H. Jennings
    • 1
    • 2
  • K. -E. Andersson
    • 1
  • S.Å. Johansson
    • 2
  1. 1.Department of Clinical PharmacologyUniversity HospitalLund
  2. 2.Department of Explorative Clinical ResearchClinical Pharmacology SectionLundSweden

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