Endocrine Abstracts

Patients with hypopituitarism and untreated growth hormone (GH) deficiency have excess mortality. GH replacement therapy (GHRT) has many beneficial effects, but its impact on mortality has not been proven and there are still safety concerns regarding the potential cancer risk. We have therefore studied the mortality in non-functioning pituitary adenoma (NFPA) patients with and without GHRT. Only patients with NFPA were studied in order to eliminate the influence of the aetiolo...

Background: Mortality rate in patients with primary and secondary adrenal insufficiency is increased. A contributing factor could be the dose and the pattern of glucocorticoid replacement therapy. Hydrocortisone administered twice or thrice daily produces high serum peaks and low trough values in-between. A novel, once daily, hydrocortisone modified release tablet with combined immediate and extended release characteristics was developed.Purpose: The aim...

Background: Patients with secondary adrenal insufficiency have an excess mortality. Data concerning the influence of the glucocorticoid replacement regime on mortality is sparse.Objective: To investigate if the total daily dose of glucocorticoid replacement has an effect on mortality in patients with non-functioning pituitary adenoma (NFPA).Method: Patients with NFPA treated for hypopituitarism in the western region of Sweden were ...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...

Introduction: GH deficiency (GHD) in adults is associated with low serum levels of insulin-like growth factor 1 (IGF1) and a deteriorated cardio-metabolic profile. GH replacement therapy (GHRT) increases serum IGF1, an important mediator of the treatment response and safety marker of dose titration. The interindividual variation in treatment response is large and most likely influenced by genetic factors.Aim: The aim of this study was to test the hypothe...

Introduction: Oral once-daily dual-release hydrocortisone (DR-HC) therapy provides a more physiological cortisol profile than conventional thrice-daily (TID) replacement therapy and has demonstrated improved metabolic profile among patients with adrenal insufficiency (AI). The mechanisms by which this metabolic improvement occurs may be due to less total exposure, changed cortisol time exposure profile, but also modified metabolism of cortisol.Objective:...

Introduction: Primary adrenal insufficiency (PAI) leads to a drastically reduced production of steroids from the adrenal cortex, but a few patients may keep some residual adrenal steroid secretion that may simplify replacement therapy and prevent adrenal crisis. Irrespectively, the conventional glucocorticoid (GC) replacement therapy, using thrice-daily oral hydrocortisone, does not restore the patients’ physiological cortisol profile.Objective: The...