The effects of inhaled corticosteroids on the endocrine system

A literature search concerning the effects of inhaled corticosteroids on the endocrine system produced 60 usable publications and reports, and numerous animal studies. Several other publications could not be considered because of inadequate data or ambiguous results. The strategy that has been adopted in presenting the outcome of this search is known as an integrated safety summary. The merit of the approach is that it enables one to address a single issue, and it makes it possible to review a large amount of sometimes haphazardly reported information. This integrated safety summary reflects the outcome of the study of the available information regarding the safety of the various corticosteroids for inhalation, and statistical examination of the evidence. The method was most useful when it was possible to reach back to individual case reports in the original material. Sometimes that was not possible. (The integrated safety summary is not aimed at rare events, and it is likely to miss them. Rather, it enables one to search for patterns, which was the purpose in this case. Patient deaths, drop-outs from clinical studies, common and clinically important adverse events, and deviations in laboratory results, are likely to have been found.)