Endocrine Abstracts

Background: Secondary adrenal insufficiency is usually treated with hydrocortisone replacement therapy twice or thrice daily in varying doses to mimic the physiological rhythm of cortisol release. However, despite efforts to optimize treatment regimens patients report impaired quality of life (QoL), including important aspects such as fatigue. A possible explanation is a suboptimal imitation of cortisol release resulting in an inadequate substitution at certain times during th...

Introduction: Maintenance immunosuppressive regimens after renal transplantation (RTx) most often include prednisolone which may induce secondary adrenal insufficiency. Adrenal insufficiency is a potentially life-threatening side effect to glucocorticoid treatment due to the risk of acute adrenal crisis. We aimed to investigate the prevalence of prednisolone-induced adrenal insufficiency in RTx patients receiving long-term low-dose prednisolone treatment.<p class="abstext"...

Introduction: Prednisolone is standard treatment of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), but many patients are reluctant to discontinue prednisolone treatment even after remission of the inflammatory conditions. Prednisolone-induced adrenal insufficiency can give manifest or latent symptoms, causing failure to taper and withdraw prednisolone. We therefore aimed to find the prevalence of adrenal insufficiency in prednisolone-treated patients with PMR/GCA...

Background and aim: The dual-release hydrocortisone Plenadren® has shown promising results of improved cardiovascular and metabolic profiles after treatment of adrenal insufficiency, possibly due to an improved circadian profile of cortisol, but results are ambiguous. Aim: To further investigate the potential effect of dual-release hydrocortisone on the metabolic profile as compared to conventional hydrocortisone in patients with secondary adrenal i...

Background: Patients on long-term glucocorticoid treatment are at risk of adrenal insufficiency during glucocorticoid treatment. The side effect can occur during glucocorticoid treatment if there is a mismatch between glucocorticoid requirements and production/intake. High-dose glucocorticoid treatment is often sufficient to overcome most stressful situations. A low-dose of 5 mg prednisolone/day is however, equivalent to 20 mg hydrocortisone, a dose often used as basal glucoco...

Objective: Glucocorticoid-induced adrenal insufficiency is highly prevalent, but the clinical consequences are not fully understood. Therefore, the indication of adding stress dosages of glucocorticoid during ongoing anti-inflammatory glucocorticoid treatment remains unclear. The aim of this study was to determine the impact of adrenal function on health-related quality of life (HRQoL) in patients receiving ongoing low-dose prednisolone treatment.Methods...

Context: Glucocorticoid-induced adrenal insufficiency is the most frequent type of adrenal insufficiency, but its symptomatology has not been thoroughly studied.Objective: To describe the predominant symptoms experienced by patients with glucocorticoid-induced adrenal insufficiency and rate these symptoms’ significance for patients’ perceived need for supplemental hydrocortisone stress dose.Methods: The 80 symptoms in the...

Introduction: Evaluation of glucocorticoid production generally requires a dynamic test. Cut-off levels for baseline cortisol concentrations predicting the outcome of a Synacthen test have been proposed for different cortisol assays. With introduction of the new Roche Elecsys Cortisol II assay, P-cortisol concentrations are expected to decrease by 20%. We have investigated cut-off levels for baseline P-cortisol concentrations measured with the Roche Elecsys Cortisol II assay t...

Background: Long-term, low-dose prednisolone treatment (≤5mg/day) is associated with adrenal insufficiency in >33% of patients. Nevertheless, the clinical consequences of glucocorticoid-induced adrenal insufficiency in patients receiving ongoing low-dose glucocorticoid treatment are unknown. Current clinical guidelines do not recommend routine evaluation of adrenal function during low-dose glucocorticoid treatment, and patients are not routinely instructed to increase gl...

Background: Glucocorticoid (GC) formulations are widely used as anti-inflammatory treatment, and synthetic GC, e.g. prednisolone, is the cornerstone treatment of polymyalgia rheumatic (PMR) and giant cell arteritis (GCA). Long-term pharmacological GC treatment may induce adrenal insufficiency (GIA). Adrenal function is, however, not routinely assessed after discontinuation of long-term GC treatment, and it is unknown, if hydrocortisone replacement is beneficial. This study aim...