Endocrine Abstracts

Background: The cortisol circadian rhythm has an early morning peak with an increase before awakening, and a second lunchtime peak. Using a UPLC-MS/MS technique to measure prednisolone, the active metabolite of prednisone, we investigated the suitability of modified release (MR) prednisone (Lodotra) as a replacement therapy.Method: Blood samples were taken at fixed time points after the administration of MR-prednisone. Concentrations of the active metabo...

Prednisolone has been reported to have greater deleterious effects on bone turnover than other glucocorticoids, although the evidence for this is confounded by the effects of higher dose prednisolone, as used in conditions such as asthma. We hypothesise that a physiological replacement dose of prednisolone will have a less dramatic effect on bone than has previously been suggested, and might be safer than hydrocortisone for replacement in adrenal insufficiency. We investigated...

Mrs. M is a 66-year-old female who has had secondary adrenal insufficiency for many years following the withdrawal of prednisolone therapy for pulmonary eosinophilia. Synacthen tests revealed complete adrenal suppression when the dose of prednisolone was weaned to 5 mg in previous years. The dose was further reduced by switching to hydrocortisone three times daily, following a 10 mg-5 mg-5 mg regimen. Occasionally, a flare of eosinophilia required restarting high-dose predniso...