Endocrine Abstracts

Background: Secondary adrenal insufficiency is usually treated with hydrocortisone replacement therapy twice or thrice daily in varying doses to mimic the physiological rhythm of cortisol release. However, despite efforts to optimize treatment regimens patients report impaired quality of life (QoL), including important aspects such as fatigue. A possible explanation is a suboptimal imitation of cortisol release resulting in an inadequate substitution at certain times during th...

Introduction: Maintenance immunosuppressive regimens after renal transplantation (RTx) most often include prednisolone which may induce secondary adrenal insufficiency. Adrenal insufficiency is a potentially life-threatening side effect to glucocorticoid treatment due to the risk of acute adrenal crisis. We aimed to investigate the prevalence of prednisolone-induced adrenal insufficiency in RTx patients receiving long-term low-dose prednisolone treatment.<p class="abstext"...

Background: Patients on long-term glucocorticoid treatment are at risk of adrenal insufficiency during glucocorticoid treatment. The side effect can occur during glucocorticoid treatment if there is a mismatch between glucocorticoid requirements and production/intake. High-dose glucocorticoid treatment is often sufficient to overcome most stressful situations. A low-dose of 5 mg prednisolone/day is however, equivalent to 20 mg hydrocortisone, a dose often used as basal glucoco...

Context: Glucocorticoid-induced adrenal insufficiency is the most frequent type of adrenal insufficiency, but its symptomatology has not been thoroughly studied.Objective: To describe the predominant symptoms experienced by patients with glucocorticoid-induced adrenal insufficiency and rate these symptoms’ significance for patients’ perceived need for supplemental hydrocortisone stress dose.Methods: The 80 symptoms in the...

Introduction: Evaluation of glucocorticoid production generally requires a dynamic test. Cut-off levels for baseline cortisol concentrations predicting the outcome of a Synacthen test have been proposed for different cortisol assays. With introduction of the new Roche Elecsys Cortisol II assay, P-cortisol concentrations are expected to decrease by 20%. We have investigated cut-off levels for baseline P-cortisol concentrations measured with the Roche Elecsys Cortisol II assay t...

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...

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...