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Table 3 Review of literature and showing the cases of iatrogenic Cushing’s syndrome and adrenal suppression from concomitant fluticasone and ritonavir therapy

From: Iatrogenic Cushing syndrome and adrenal insufficiency during concomitant therapy with ritonavir and fluticasone

Authors Age RTV dose (mg/day) ICS dose (mcg/day) Durationa Intervention
Mahlab-Guri and Asher (2011)
 Case 1 12 F 200 Fluticasone 200 6 months Fluticasone replaced by montelukast
 Case 2 55 F 200 Fluticasone 1000 3 weeks Fluticasone replaced by budesonide
 Case 3 65 F 200 Fluticasone 500 6 months Fluticasone discontinued
Kaviani et al. (2011)
 Case 1 60 M NA Fluticasone 1200 2 years Fluticasone discontinued
Kedem et al. (2010)
 Case 1 F NA NA UNK Fluticasone and budesonide discontinued
      Ritonavir dose decreased
Samaras et al. (2005)
 Case 1 43 M 200 Fluticasone 500 2 years Fluticasone discontinued
 Case 2 43 M 100 Fluticasone 1000 18 months Fluticasone discontinued
 Case 3 53 M 200 Fluticasone 1000 2 years Fluticasone discontinued
 Case 4 49 M 200 Fluticasone 1000 6 weeks PI discontinued
 Case 5 43 M 200 Fluticasone 500 4 months Fluticasone discontinued
 Case 6 50 M 100 Fluticasone 1000 2 months Fluticasone discontinued
Nocent et al. (2004)
 Case 1 38 M NA Fluticasone 2000 1.5 months Fluticasone replaced with beclomethasone
Leitman et al. (2009)
 Case 1 49 M NA Fluticasone 1000 UNK Fluticasone dose reduced
Valin et al. (2009)
 Case 1 65 F NA Fluticasone 500 6 months Fluticasone discontinued
 Case 2 66 M NA Fluticasone 500 1 month Fluticasone discontinued
 Case 3 66 M NA Fluticasone 500 2 years Fluticasone discontinued
 Case 4 29 M NA Fluticasone 2000 1 month Fluticasone discontinued PI replaced with nelfinavir
Jinno and Goshima (2008)
 Case 1 60 M NA Fluticasone NA 18 months Fluticasone discontinued
Gillett et al. (2005)
 Case 1 27 F 200 Fluticasone 1000 10 weeks Fluticasone discontinued
Soldatos et al. (2005)
 Case 1 66 M 200 Fluticasone 1000 4 months Fluticasone dose decreased
 Case 2 66 M 200 Fluticasone 1000 6 months Fluticasone replaced with budesonide
Rouanet et al. (2003)
 Case 1 44 M 266.4 Fluticasone 2000 2 months Fluticasone discontinued
Gupta and Dubé (2002)
 Case 1 45 M 800 Fluticasone 880 5 months Fluticasone tapered
Clevenbergh et al. (2002)
 Case 1 33 M 200 Fluticasone 1000 5 months Fluticasone discontinued
Chen et al. (1999)
 Case 1 32 M   Fluticasone 400 5 months Fluticasone discontinued
 Case 2 39 M   Fluticasone 800 18 months Fluticasone discontinued
Hillebrand-Haverkort et al. (1999)
 Case 1 30 M 1200 Fluticasone 200 5 months RTV replaced by NVP
Arrington-sanders et al. (2006)
 Case 1 11.4 F 133 Fluticasone 220   Fluticasone and PI discontinued
 Case 2 20.9 M 100 Fluticasone 200   Fluticasone discontinued
 Case 3 16.8 M 200 Fluticasone 250   Stopped all medications
 Case 4 9.5 M 133 Fluticasone 220   Fluticasone discontinued
 Case 5 1.8 F 60 Fluticasone 220   Fluticasone discontinued
Johnson et al. (2006)
 Case 1 12 F 134 Fluticasone 500 2 months RTV/LPV D/C
 Case 2 15 F 200 Fluticasone 1000 13 weeks Fluticasone dose decreased
Pessanha et al. (2007)
 Case 1 16 F NA Fluticasone 500 3 months RTV replaced by EFV
St Germain et al. (2007)
 Case 1 14 F 100 Fluticasone 500 2 weeks Fluticasone discontinued
      RTV/ATV with held
Bhumbra et al. (2007)
 Case 1 9 M 108 Fluticasone 440 2 months Fluticasone discontinued
    Mometasone 100 11 months Mometasone discontinued
le Roux et al. (2001)
 Case 1 47 M   Budesonide 1600   Budesonide discontinued
Sagir et al. (2002)
 Case 1 48 M   Budesonide 9000 19 days Budesonide discontinued
  1. RTV ritonavir, LPV lopinavir, ICS inhaled corticosteroids, EFV efavirenz, PI protease inhibitors, ATV atazanavir, NA not available, UNK unknown, NVP nevirapine
  2. aDuration until onset of first symptoms