Endocrine Abstracts

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...

Background: Correctly identifying glucocorticoid-induced adrenal insufficiency in patients tapering prednisolone treatment to ≤5 mg daily is crucial. Pausing prednisolone before an ACTH-test is standard, yet the optimal pause duration is uncertain.Aim: To determine the outcome of an ACTH-test after 1 vs 2 days’ prednisolone pause before the test.Methods: Baseline data from an ongoing randomised clinical trial (EudraCT:20...

Objectives: The clinical impact of glucocorticoid-induced adrenal insufficiency in patients on low-dose prednisolone is unclear. We investigated the influence of adrenal function on health-related quality of life (HRQoL) in patients tapering prednisolone.Method: Baseline data from an ongoing prospective randomised clinical trial including 278 patients with polymyalgia rheumatica/giant cell arteritis treated with prednisolone for ≥12 weeks, current ...

Background: Pharmacological glucocorticoid (GC) treatment exerts adverse effects on musculoskeletal health and may induce glucocorticoid-induced adrenal insufficiency (GIA), but these features have so far not been characterized in a prospective and unbiased manner.Aim: To characterize a population, who recently discontinued long-term (>12 weeks) prednisolone treatment with particular emphasis on the presence or absence of symptoms.<p class="abste...

Background and aim: Identifying patients with glucocorticoid-induced adrenal insufficiency poses a challenge. We investigated whether factors associated with exogenous hypercortisolism (as a proxy of overall elevated glucocorticoid exposure) could predict the risk of glucocorticoid-induced adrenal insufficiency in patients with polymyalgia rheumatica and/or giant cell arteritis during long-term low-dose prednisolone treatment.Material and methods: Baseli...

Background: Long-term prednisolone therapy may lead to subtle changes in circadian oscillations of the hypothalamic-pituitary-adrenal axis, which can affect quality of life of the patient. Low score of the Addison’s disease-specific quality-of-life questionnaire (AddiQoL-30) could be a method to assess functional glucocorticoid-induced adrenal insufficiency.Objective: To compare scores from AddiQoL-30 with generic Short Form (SF-36) questionnaire in...

Background: Glucocorticoid-induced adrenal insufficiency (GIA) may occur after termination of long-term glucocorticoid (GC) treatment. GIA is usually diagnosed by a short-synacthen-test (SST), but peak cortisol response to SST may not validly assess normalisation of the diurnal hypothalamic-pituitary-adrenal (HPA)-axis. In patients with polymyalgia rheumatic (PMR) and giant cell arteritis (GCA), we report at this meeting a surprisingly low prevalence of GIA of 1.6% after cessa...

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...