Effects of mometasone furoate dry powder inhaler and beclomethasone dipropionate hydrofluoroalkane and chlorofluorocarbon on the hypothalamic-pituitary-adrenal axis in asthmatic subjects

Chest. 2005 Jul;128(1):70-7. doi: 10.1378/chest.128.1.70.


Study objectives: Mometasone furoate dry powder inhaler (MF-DPI) [400 mug] is an inhaled corticosteroid (ICS) that is effective in the treatment of asthma. MF-DPI has a low potential for suppression of the hypothalamic-pituitary-adrenal (HPA) axis at its clinical dose. The effect of MF-DPI, 400 microg qd, on the HPA axis was compared to that of beclomethasone dipropionate (BDP) using hydrofluoroalkane (HFA) and chlorofluorocarbon (CFC) propellants via metered-dose inhalers (MDIs) twice daily.

Design and interventions: This randomized, third-party blind, parallel-group study compared the effects of MF-DPI 400 mug one puff qd in the morning (n = 18), HFA-BDP 200 microg two puffs MDI bid (n = 18), and CFC-BDP 400 microg two puffs MDI bid (n = 17) for 14 days on the area under the 24-h serum cortisol concentrations curve (AUC(0-24)) and on total 24-h urinary free cortisol excretion in mild asthmatic subjects. Effects on morning/evening peak expiratory flow (PEF) and on inhaled albuterol use were also assessed. Adverse events that occurred during or > or = 30 days after the study were recorded.

Results: The mean decrease from baseline in the serum cortisol concentrations AUC(0-24) in the MF-DPI group was significantly less than in either the HFA-BDP (p = 0.024) or the CFC-BDP (p = 0.011) groups. Decreases in serum cortisol concentrations AUC(0-24) in the two BDP groups did not differ from one another. The MF-DPI group trended toward higher morning and evening PEF than either BDP group. Treatment-associated adverse events were reported by seven subjects in the MF-DPI group, vs one subject in the HFA-BDP and three subjects in the CFC-BDP groups; these were mild, and no subject discontinued treatment due to an adverse event.

Conclusions: Fourteen days of treatment with MF-DPI 400 microg qd was associated with a significantly lesser decrease in the serum cortisol concentrations AUC(0-24) compared with HFA-BDP 200 microg MDI or CFC-BDP 400 microg MDI bid.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Aerosol Propellants / administration & dosage
  • Aerosol Propellants / pharmacology*
  • Aged
  • Analysis of Variance
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / pharmacology*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / pharmacology*
  • Area Under Curve
  • Asthma / drug therapy*
  • Beclomethasone / administration & dosage
  • Beclomethasone / pharmacology*
  • Chlorofluorocarbons / administration & dosage
  • Chlorofluorocarbons / pharmacology*
  • Creatinine / urine
  • Female
  • Humans
  • Hydrocarbons, Fluorinated / administration & dosage
  • Hydrocarbons, Fluorinated / pharmacology
  • Hydrocortisone / blood
  • Hypothalamo-Hypophyseal System / drug effects*
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mometasone Furoate
  • Pituitary-Adrenal System / drug effects*
  • Pregnadienediols / administration & dosage
  • Pregnadienediols / pharmacology*


  • Aerosol Propellants
  • Anti-Asthmatic Agents
  • Anti-Inflammatory Agents
  • Chlorofluorocarbons
  • Hydrocarbons, Fluorinated
  • Pregnadienediols
  • Mometasone Furoate
  • Creatinine
  • Beclomethasone
  • Hydrocortisone