Endocrine Abstracts

Introduction: The daily maintenance dose of conventional hydrocortisone currently recommended by international guidelines for the management of primary adrenal insufficiency (PAI) or secondary adrenal insufficiency (SAI) is 15−25 mg/day, in 2−3 divided doses. The aim of this analysis was to investigate inter-country differences in glucocorticoid replacement doses in patients with PAI and SAI.Design: EU-AIR (ClinicalTrials.gov identifier: NCT0...

Introduction: If untreated, adrenal insufficiency (AI) leads to premature death. Hospital record data suggest mortality associated with primary (PAI) and secondary AI (SAI) to be 2–3-fold higher than in the general population. Major causes of death include cardiovascular disease, Addisonian crises, brain tumours and infections; however, there is little further characterization of patients who died.Design: We analysed real-world data from the Europea...

Introduction: Adrenal crises (ACs) are life-threatening events in patients with primary (PAI) or secondary (SAI) adrenal insufficiency, occurring ~4–10 times per 100 patient-years. Major causes of ACs are infections, especially gastroenteritis and tonsillitis/laryngitis. Risk factors for ACs remain ill defined, but could include concomitant endocrine diseases (diabetes mellitus, premature ovarian failure) in PAI, diabetes insipidus in SAI, and concomitant non-endocrine di...

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: 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: 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...

Introduction: Current understanding about the frequency of adrenal crisis in patients with adrenal insufficiency (AI) relies exclusively on retrospective data (~6.3 adrenal crisis per 100 patient-years). In addition, no data are available about the frequency of intercurrent illness events in AI patients. For the first time we prospectively used a patient’s diary in recording events of adrenal crisis and intercurrent illness in AI patients.Design: Th...

Introduction: Data concerning patients with adrenal insufficiency (AI) have been limited by small numbers of patients reflecting the relatively low prevalence of this disease. The European Adrenal Insufficiency Registry (EU-AIR) is a multicenter observational study of patients with both primary and secondary AI. Enrollment commenced August 2012. Comprehensive demographic data, aetiology of AI, and details of glucocorticoid replacement therapy are collected at baseline. Safety ...