Endocrine Abstracts

Introduction: Treatment of patients with acromegaly is complex, including surgery, pharmacotherapy and radiotherapy. The objective was to describe comorbidities and treatment patterns among patients with acromegaly in Sweden.Methods: Population-based study including all patients with a first diagnosis of acromegaly due to a pituitary adenoma in Sweden between 1 Jul 2005 and 31 Dec 2013. Data was obtained via linkage of the National Patient Register, Swed...

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...

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: Current guidelines recommend that susceptible patients should be tested and treated for AGHD. Still, it is not universally recognised as a distinct entity and reimbursement of GH replacement therapy is not available in some countries.Aim: 1) to record current practice of AGHD management throughout Europe and benchmark it against existing guidelines, 2) to evaluate educational status of health care professionals.Patients...

Introduction: Hyponatremia (HN) is the most common electrolyte disorder of hospitalized patients (pts). It occurs in up to 28% of in-pts, increases the in hospital risk of death by 1.47 fold, and is associated with significantly higher mortality risk following discharge. The HN Registry is the first large scale, international effort to document the clinical characteristics, treatments used, and impact of HN in hospital settings.Methods: After informed co...

Introduction: Current management of intercurrent illness (ICI) in adrenal insufficiency (AI) is inadequate. We attempted to optimise ICI regimens with pharmacokinetic simulations of a dual-release (DR) hydrocortisone (HC) and tested them in a formal clinical trial.Methods: This work consisted of: i) dosing recommendations in episodes of mild ICI with DR-HC using simulations with a population pharmacokinetic model, ii) collection of ICI episodes with incr...

Background: Patients with Cushing’s syndrome (CS) in long-term remission have impaired cognitive function. Cerebrospinal fluid (CSF) biomarkers are important diagnostic tools in the work-up of patients with cognitive impairment. The aim of this study was to analyze biological markers in CSF from patients with CS in remission. Owing to the overlapping similarities between patients with CS and dementia, i.e. cognitive dysfunction and hypercortisolemia, the main hypothesis w...

Background: Hypopituitary patients with untreated growth hormone deficiency (GHD) have increased fat mass, dyslipidaemia and insulin resistance. Inappropriately low thyroxine doses in patients with central hypothyroidism (CH) may also promote such clinical features.Objective: To examine metabolic outcome of thyroxine replacement in hypopituitary patients before and after GH replacement.Method: One thousand and six hundred and two p...

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: The prevalence of type 1 diabetes mellitus (DM) among patients with primary adrenal insufficiency (Addison’s disease) is 3-4 times higher than the expected prevalence in the population. The mortality rate due to DM is more than 3-fold the mortality rate in the background population. The impact of DM on mortality rate in patients with Addison’s disease is not known.Objectives: To study the frequency of DM and its impact on mortality ...