SFEBES2016 Poster Presentations Adrenal and Steroids (41 abstracts)
Could modified release prednisone hold the key to closer reproduction of the glucocorticoid circadian rhythm in Adrenal Insufficiency?
Sirazum M Choudhury 1, , Adam Leckey 2 , Emma L Williams 1 , Tricia M Tan 1, & Karim Meeran 1,
1Imperial College Healthcare NHS Trust, London, UK; 2Imperial College London, London, UK.
Background: The cortisol circadian rhythm has an early morning peak with an increase before awakening, and a second lunchtime peak. Using a UPLC-MS/MS technique to measure prednisolone, the active metabolite of prednisone, we investigated the suitability of modified release (MR) prednisone (Lodotra) as a replacement therapy.
Method: Blood samples were taken at fixed time points after the administration of MR-prednisone. Concentrations of the active metabolite prednisolone, were determined by UPLC-MS/MS, and were plotted against time to produce prednisolone day curves.
Results: Administration of MR-prednisone led to undetectable prednisolone levels up to 4 h. TMax was achieved at approximately 5 h with an ensuing steady decline in prednisolone levels. The morphology of the curve at this point was congruent with those seen with prednisolone administration.
Conclusion: A night-time dose of MR-prednisone can be used to create an early morning peak in prednisolone levels before awakening, and can thus closely mimic the pre-awakening steroid rise that occurs in a normal diurnal rhythm.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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