ECE2022 Rapid Communications Rapid Communications 7: Pituitary and Neuroendocrinology 2 (7 abstracts)
Does the postoperative dose of hydrocortisone influence the health-related quality of life in patients with cured Cushing syndrome?
Ivana Kraljevic 1,2 , Anja Barac 3 , Mirsala Solak 1 , Tanja Skoric Polovina 1 , Annemarie Balasko 1 , Karin Zibar Tomsic 1 , Tina Dusek 1,2 & Darko Kastelan 1,2
1University Hospital Center Zagreb, Dpt of Endocrinology, Zagreb, Croatia; 2Zagreb University School of Medicine, Zagreb, Croatia; 3General Hospital Dubrovnik, Division of Internal Diseases, Dubrovnik, Croatia
Objective: Patients with Cushing syndrome (CS) have impaired health-related quality of life (HRQoL) before and after surgery. The data on the optimal hydrocortisone dose after surgical cure of CS is scarce. Therefore, we investigated the influence of hydrocortisone dose on HRQoL after surgical treatment of CS. We hypothesized that patients who receive higher hydrocortisone doses after surgery would have better HRQoL and fewer cortisol withdrawal symptoms.
Methods: The study population comprised 38 patients with CS, 18 with adrenal, and 20 with pituitary origin. After surgical remission of CS, patients were randomized to 15 mg or 30 mg of hydrocortisone. All patients completed the EQ-5D questionnaire at baseline, one month, and three months after surgery. In addition, data on symptoms related to cortisol withdrawal and the consequent need for hydrocortisone dose escalation were collected.
Results: The HRQoL did not differ between patients receiving 15 mg (22 patients) or 30 mg (16 patients) of hydrocortisone, at baseline, after one month, or three months after curative surgery. Total EQ-5D scores in patients on 15 mg and 30 mg of hydrocortisone were 60(1-90) vs 60(0-100), 70(3-85) vs 45(2-95), and 80(20-100) vs 52.5(20-100), respectively (P=0.934, P=0.308, and P=0.544). Three patients needed a temporary increase of hydrocortisone dose during follow-up due to acute illness or worsening of symptoms.
Conclusions: This prospective randomized study showed no difference in HRQoL between patients receiving 15 or 30 mg of hydrocortisone replacement therapy in the first three months after the surgical remission of CS.
Volume 81
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Endocrine Abstracts
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