ECE2015 Guided Posters Pituitary – Hypopituitarism (9 abstracts)
Somatic complaints, pain and health related quality of life in patients treated for secondary adrenal insufficiency – results from a randomised controlled trial
Jorien Werumeus Buning 1 , Pauline Brummelman 1 , Janneke Koerts 2 , Robin P F Dullaart 1 , Gerrit van den Berg 1 , Melanie M van der Klauw 1 , Oliver Tucha 2 , Bruce H R Wolffenbuttel 1 & André P van Beek 1
1University Medical Center Groningen, Groningen, The Netherlands; 2University of Groningen, Groningen, The Netherlands.
Introduction: There is growing evidence that quality of life (QoL) in patients with adrenal insufficiency (AI) is impaired. Undertreatment with glucocorticoids is associated with symptoms such as fatigue and gastrointestinal complaints whereas overtreatment is associated with impaired QoL. However, evidence for this is derived from observational studies which are prone to bias. Therefore, the aim of the present study was to compare two different physiological doses of hydrocortisone (HC) on somatic complaints, pain and QoL in an RCT.
Methods: Forty-seven patients (29 males, 18 females; mean (S.D.) age, 51(14) years) with secondary AI participated. In this RCT with cross-over design, patients received first a lower dose of HC (0.2–0.3 mg/kg body weight/day in three divided doses) for 10 weeks followed by a higher dose of HC (0.4–0.6 mg/kg body weight/day in three divided doses) for 10 weeks, or vice versa. Health related quality of life was assessed with questionnaires after each treatment period and daily with a mood and symptom checklist.
Results: After 10 weeks on the higher dose of HC patients reported significantly fewer depressive symptoms (P=0.016) (Hospital Anxiety and Depression Scale), less general and mental fatigue (P=0.004 and P=0.003, respectively), less reduced motivation (P=0.021) (Multidimensional Fatigue Inventory-20) compared to the lower dose. Furthermore, after treatment with the higher dose patients reported better physical functioning (P=0.041), general health (P=0.013) and more vitality (P=0.025) (RAND-36). In addition, while on the higher dose fewer somatic symptoms (P=0.022) (Patient Health Questionnaire-15) and less pain (P < 0.001) were experienced.
Conclusion: While on the higher dose of HC, patients reported a better quality of life with regard to general health, mental health, depressive symptoms, common somatic complaints, pain and fatigue compared to the lower dose of HC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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