Endocrine Abstracts

Introduction: In many endocrine centres the 250μg Short Synacthen (Cosyntropin) Test (SST) is the reference standard for the diagnosis of adrenal insufficiency (AI) 1, but it is time consuming, expensive, and requires hospital attendance and venepuncture. The morning physiological peak of cortisol shortly after waking is a good predictor for a negative SST; however, a morning serum cortisol requires venepuncture. Serum cortisol and salivary cortisone correlate ...

Introduction: The 250µg Short Synacthen test (SST) is the reference standard for a diagnosis of adrenal insufficiency (AI) in most endocrine centres. The test is expensive and time consuming, requiring clinic attendance. We hypothesised that a cheaper home waking salivary cortisone (WSC) is predictive of the SST 30-minute cortisol >430 nmol/l cut-off and carried out a diagnostic accuracy study to assess the predictive value of the WSC in diagnosing and excluding AI. W...

The onset of human lactation is characterised by increased breast fullness and the start of copious milk secretion. The process, which typically occurs 1-4 days postpartum, is triggered by a decrease in serum progesterone and high prolactin concentrations, although the exact levels are ill-defined. We aim to establish reference intervals for hormones triggering the onset of sustained lactation and understand how breastfeeding influences hormone secretion, so as to improve the ...

Introduction: In two Phase III studies (LINC3, NCT02180217; LINC4, NCT02697734), osilodrostat, (potent oral 11β-hydroxylase inhibitor), provided rapid, sustained reductions in mean urinary free cortisol (mUFC) and late-night salivary cortisol (LNSC), alongside improvements in clinical signs of hypercortisolism and health-related quality of life (HRQoL), in Cushing’s disease (CD) patients. mUFC and LNSC are recommended for monitoring treatment response. We assessed wh...

Introduction: Phase II (LINC2, NCT01331239) and Phase III (LINC3, NCT02180217; LINC4, NCT02697734) studies showed that osilodrostat, a potent oral 11β-hydroxylase inhibitor, was an effective long-term treatment for Cushing’s disease patients. In this LINC programme pooled analysis, we examined how dose uptitration and adjustments during long-term maintenance can provide rapid, sustained mean urinary free cortisol (mUFC) control, and minimise AEs.<p class="abstext...

Resistance to Thyroid Hormone alpha (RTHα) is characterised by tissue-selective hypothyroidism with near-normal thyroid function tests, and is due to thyroid receptor α gene mutations. We sought to correlate the clinical characteristics and response to thyroxine treatment of two RTHα patients with the properties of their defective TRα proteins.Clinical, biochemical and physiological parameters were assessed in each patient at baseline...

Introduction: Worldwide the Short Synacthen Test (SST) is the most popular investigation for adrenal insufficiency (AI). Its invasivity make it resource-intensive. Salivary cortisol is a well-established alternative to serum. We have developed a non-invasive alternative to the SST, using a novel formulation of Synacthen (containing a drug enhancer, chitosan) administered nasally and utilising saliva to measure glucocorticoid response.Methods: Four open-l...

Introduction: Patients with Cushing’s disease (CD) have an increased risk of hypertension (HTN). phase III data have shown that pasireotide leads to rapid reductions in UFC levels and significant improvements in CD symptoms. We now present further analyses of these data, evaluating the effects of pasireotide on HTN in patients with CD.Methods: Patients with persistent/recurrent or de novo (if not surgical candidates) CD and UFC≥1.5 time...

Introduction: Pasireotide is a multi-receptor targeted somatostatin analogue with high affinity for sst5, which is commonly expressed in corticotroph adenomas, thus having potential as therapy for Cushing’s disease.Methods: One hundred and sixty-two patients with persistent/recurrent or de novo (if not surgical candidates) Cushing’s disease were randomized (double-blind) to pasireotide 600 μg (n=82) or 900 μg ...

Introduction: The multi-receptor targeted somatostatin analogue pasireotide has demonstrated efficacy in reducing cortisol in patients with Cushing’s disease in a large, randomized, double-blind, Phase III study. The effects of pasireotide on the signs and symptoms of Cushing’s disease were also investigated as secondary objectives in this trial.Methods: Adult patients with persistent/recurrent or de novo Cushing’s disease were rand...