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...

Background: Replicating the physiological cortisol secretion is key in treatment of glucocorticoid insufficient individuals. A sub-optimal replication may explain the impaired quality of life experienced by these individuals. The study investigates fatigue measured by ecological momentary assessments in patients treated with conventional hydrocortisone compared with a once-daily dual-release formula of hydrocortisone (Plenadren) that follows the cortisol physiology more closel...

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...

Introduction: Some methodologists have raised concern about the validity of the standard method of assessing patient-reported outcomes, i.e. retrospective questionnaires. Repeated momentary measurements have been introduced to avoid recall bias and provide ecological validity. Although having theoretical advantages, the measurement properties remain unsubstantiated. This study examines the relationship between the retrospective thyroid-related quality of life patient-reported ...

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...

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...