Susceptibility to corticosteroid-induced adrenal suppression: a genome-wide association study

Inhaled corticosteroids (ICS) are widely used by patients with asthma or chronic obstructive pulmonary disease (COPD). Although ICS are generally well tolerated and have fewer systemic adverse effects than oral corticosteroids, some patients develop systemic adverse effects. Adrenal suppression is a clinically important adverse effect, particularly in children with asthma, but its detection is challenging because presentation can range from asymptomatic biochemical changes to non-specific lethargy to florid adrenal crisis and death. The aim of the Pharmacogenetics of Adrenal Suppression with Inhaled Steroids (PASS) study was to undertake the first pharmacogenomic assessment of corticosteroid-induced adrenal suppression among children with asthma using ICS.