Endocrine Abstracts

Novel biopharmaceutical techniques have allowed the development of a hydrocortisone modified release (MR) tablet (once-daily administration for replacement therapy in adrenal insufficiency) mimicking more closely the physiological serum cortisol profile. Robust bioavailability is needed to secure this new treatment safety.Aims: To compare single-dose pharmacokinetics (PK) of MR tablets manufactured at two different sites by assessing intra-subject variab...

Conventional therapy for chronic hypoparathyroidism is oral calcium and active vitamin D; despite treatment, chronic hypoparathyroidism may be associated with increased risk of renal complications. Without the effect of parathyroid hormone on renal tubular reabsorption, calcium-conserving and phosphaturic effects are lost, serum calcium levels are reduced and serum phosphate levels are increased. This may lead to hypercalciuria and hyperphosphataemia, which may be associated w...

Hypoparathyroidism is a rare disorder characterised by hypocalcaemia and hyperphosphataemia in the presence of low or inappropriately normal parathyroid hormone levels. Currently there are limited data on the burden of illness and healthcare resource utilisation (HCRU) associated with chronic hypoparathyroidism in Canada. A retrospective cohort analysis with matched controls was conducted to examine HCRU in patients with chronic hypoparathyroidism in Ontario, Canada. Data were...

Introduction: Prednisolone is the standard treatment for most inflammatory conditions. However, it is also used in hormone replacement therapy in adrenal insufficiency (AI) for historical reasons or due to its longer half-life and once-daily application. Recent data indicate that daily prednisolone could be associated with lower bone mineral density than daily hydrocortisone in patients with AI. However, data on risk factors for cardiovascular disease in patients with AI treat...

Introduction: Patients with adrenal insufficiency (AI) (primary (PAI), secondary to pituitary disease (PIT) and congenital adrenal hyperplasia (CAH)) have reduced life expectancy with reported standardized mortality ratios of ~2:1 but given the rarity of AI, the underlying explanation remains largely unknown.Objective: To evaluate patient characteristics, prevalence of concomitant conditions and hospitalization incidence in patients with AI compared to a...

Introduction: Prednisolone is the standard treatment for most inflammatory conditions. However, it is also used in hormone replacement therapy in adrenal insufficiency (AI) due to historical reasons or due to its longer half-life and once daily application. Recent data showed that 5 mg daily prednisolone promotes loss in bone mineral density compared to 20 mg of hydrocortisone in patients with AI questioning the 4:1 conversion rate. Data is scarce on prednisolone treated AI pa...

Introduction: Glucocorticoid (GC) replacement therapy is administered to patients with adrenal insufficiency (AI) in multiple daily doses; however, there are no consensus guidelines on the optimal regimen.Methods: The European Adrenal Insufficiency Registry (EU-AIR) is a multinational, multicentre, observational study sponsored by Shire, initiated to monitor the long-term safety of GC replacement in patients with chronic AI. We analysed baseline data to ...

Introduction: The clinical outcome of patients with adrenal insufficiency (AI) has been shown to be less favorable than previously thought. Clinical studies have shown increased mortality, reduced cardiovascular and skeletal health and compromised quality of life, but the impact of this upon healthcare burden is unknown. This research utilised real-world evidence to compare comorbidities, healthcare utilization and expenditures in patients with AI.Method...

Introduction: No consensus guidelines currently exist as to the optimal glucocorticoid regimen in adrenal insufficiency (AI). In clinical practice physicians utilise a number of different glucocorticoids, usually administered in several doses throughout the day.Methods: The EU-AIR registry is a European multinational, multicentre, prospective, observational study sponsored by Shire inclusive of all patients with AI irrespective of aetiology. We analysed ...

Introduction: During recent years many authors have advocated lower hydrocortisone doses in patients with primary adrenal insufficiency (PAI) mainly due to worries for non-physiological effects like increased cardiovascular risk and bone resorption, but very little attention has been drawn to fludrocortisone dosing. Our main hypothesis was that that the higher hydrocortisone dose, the lower the fludrocortisone dose and vice versa.Design: The Eur...