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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