Endocrine Abstracts

Androgen deficiency may contribute to sexual dysfunction in hypoadrenalism but its role in normal female physiology is uncertain. The aim of this study was to determine the role of androgens in the aetiology of sexual dysfunction in healthy women. Twenty-nine premenopausal women with loss of libido (subjects) and 13 healthy females (controls) were studied. They were aged 18 to 45 years and in a stable heterosexual relationship. Venous blood was taken at 9 am in the follicular ...

Case History: A 47-year-old man presented to his GP in November 2019 with sudden onset polydipsia, polyuria and large volume nocturia, passing approximately 5L of urine daily. He was drinking to thirst, had no past medical or family history, and was not taking any medication. He had normal serum calcium, sodium and HbA1c. His GP referred to the local endocrinologist. Five months later, he was referred to our tertiary centre for a water deprivation test, as it had not been poss...

Background: Cut-offs for basal cortisol (early morning) have been determined to predict the 30-minute cortisol level post-synacthen, but not for determining when patients with suspected tertiary adrenal insufficiency (AI) are weaned off glucocorticoids.Aims: The aim of this study was to compare the predictive values of basal cortisol, basal ACTH and basal cortisol:ACTH ratio to determine appropriate thresholds to reduce ...

Background: Long-term glucocorticoids can result in iatrogenic Cushing’s syndrome with adrenal suppression. Most patients reactivate their hypothalamic-pituitary-adrenal axis once they’re weaned off glucocorticoids. During glucocorticoid withdrawal, many clinicians switch patients to hydrocortisone to benefit from its short half-life1. However, in some patients, hypothalamic-pituitary-adrenal axis recovery is delayed despite the above. It is unclear whethe...

Background: Improving physical manifestations of hypercortisolism is an important treatment goal for patients with Cushing’s disease (CD). In the Phase III LINC 3 study (NCT02180217), osilodrostat therapy, a potent oral 11β-hydroxylase inhibitor, rapidly normalised mean urinary free cortisol (mUFC) in most patients with CD and sustained control of mUFC over a median treatment period of 130 weeks (W). Here we describe concomitant improvements in physical manifestation...

Introduction: Osilodrostat decreases cortisol production by inhibiting 11β-hydroxylase, increasing adrenal hormones above the blockade. Here, we describe these effects of osilodrostat and associated adverse events (AEs). The efficacy and safety of osilodrostat in patients with Cushing’s disease (CD) were confirmed in the published Phase III, prospective LINC 3 study (NCT02180217).Methods: 137 patients with CD (mUFC >1.5x upper limit of norm...

Background: 24-h mean urinary free cortisol (mUFC) and late-night salivary cortisol (LNSC) levels are complementary parameters recommended for screening and monitoring treatment response in patients with Cushing’s disease (CD). In the published core period of the Phase III LINC 3 study (NCT02180217), therapy with osilodrostat (potent oral 11β-hydroxylase inhibitor) produced rapid, sustained reductions in mUFC and LNSC alongside improvements in clinical signs of hyper...

Background: Patient experience is a crucial part of patient care, but is not systematically assessed. In light of this we performed a UK-wide survey to understand the care experiences of patients with pituitary conditions over the preceding three years.Methods: In collaboration with patients and pituitary experts a web-based survey was designed, aimed at patients 18yrs and over. Specific topics included: assessment of information provision, communication...

Background: Symptom management is a cornerstone of clinical care, particularly for patients with cancer. However, often patient’s symptoms go undetected by health care providers between clinic visits. Mobile health applications are increasingly used in oncological care to support cancer patients.Aims: To develop a patient focussed mobile application to enable patients to track symptoms, record quality of life, communicate with their clinical teams a...

Introduction: Lutetium-177 Oxodotreotide (Lutathera) is a targeted molecular radiotherapy treatment for advanced, inoperable, progressive neuro-endocrine tumours. We present our experience of Lutathera therapy with particular focus on our experience implementing treatment as a day-case procedure, and assessment of adherence to treatment quality standards surrounding the administration.Aims: To assess safety of Lutathera as a day-case treatment.<p cla...