Endocrine Abstracts

Worldwide, a care gap has been recognized between presenting with a fragility fracture and prevention of the next fracture. Fracture Liaison Service is the most cost-effective method to close this gap, but its implementation is sparse in many countries. To assess the need for a subsequent fracture prevention program in Denmark, we conducted a cross-sectional study – named OFELIA - aiming to estimate the prevalence of osteoporosis in a Danish cohort of fragility fracture p...

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: Myopathy is a known and dreaded adverse effect of pharmacological glucocorticoid (GC) treatment, but its impact on daily physical activity is not known.Aim: To measure spontaneous physical activity and musculoskeletal function in patients shortly after planned cessation of long-term (>12 weeks) prednisolone treatment.Patients and methods: Baseline data from an ongoing nation-wide prospective study (DOUBLE EDGE &#1...

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: The risk and course of glucocorticoid-induced adrenal insufficiency (GIA) are unclear and current evidence is retrospective and based on small and selected study populations. However, the prevalence of glucocorticoid use is at least 3 %, which underscores the need for unbiased and prospective assessment of the prevalence and clinical consequences of GIA.Objectives: To identify biomarkers of GIA as regards diagnosis, prognosis and responsivene...

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...

Background: Correctly identifying glucocorticoid-induced adrenal insufficiency in patients tapering prednisolone treatment to ≤5 mg daily is crucial. Pausing prednisolone before an ACTH-test is standard, yet the optimal pause duration is uncertain.Aim: To determine the outcome of an ACTH-test after 1 vs 2 days’ prednisolone pause before the test.Methods: Baseline data from an ongoing randomised clinical trial (EudraCT:20...

Objectives: The clinical impact of glucocorticoid-induced adrenal insufficiency in patients on low-dose prednisolone is unclear. We investigated the influence of adrenal function on health-related quality of life (HRQoL) in patients tapering prednisolone.Method: Baseline data from an ongoing prospective randomised clinical trial including 278 patients with polymyalgia rheumatica/giant cell arteritis treated with prednisolone for ≥12 weeks, current ...

Background: Pharmacological glucocorticoid (GC) treatment exerts adverse effects on musculoskeletal health and may induce glucocorticoid-induced adrenal insufficiency (GIA), but these features have so far not been characterized in a prospective and unbiased manner.Aim: To characterize a population, who recently discontinued long-term (>12 weeks) prednisolone treatment with particular emphasis on the presence or absence of symptoms.<p class="abste...

Background and aim: Identifying patients with glucocorticoid-induced adrenal insufficiency poses a challenge. We investigated whether factors associated with exogenous hypercortisolism (as a proxy of overall elevated glucocorticoid exposure) could predict the risk of glucocorticoid-induced adrenal insufficiency in patients with polymyalgia rheumatica and/or giant cell arteritis during long-term low-dose prednisolone treatment.Material and methods: Baseli...