Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Adrenal insufficiency is seen in more than one-third of patients during ongoing low-dose prednisolone treatment for rheumatoid arthritis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Safety and convenience of once-weekly somapacitan in adult GH deficiency: a 26-week randomized, controlled trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. SGLT2 inhibitors: Clinical benefits by restoration of normal diurnal metabolism?

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  4. Genetic influence on the associations between IGF-I and glucose metabolism in a cohort of elderly twins

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Brain tumours in children and adolescents may affect the circadian rhythm and quality of life

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Thyroid function in COVID-19 and the association with cytokine levels and mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Prevalence of Pathogenic Germline DICER1 Variants in Young Individuals Thyroidectomised Due to Goitre - A National Danish Cohort

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Comparison of treatment retention and response to secukinumab versus tumour necrosis factor inhibitors in psoriatic arthritis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVE: Patients receiving long-term glucocorticoid treatment are at risk of developing adrenal insufficiency during treatment. We investigated the prevalence of prednisolone-induced adrenal insufficiency in the particular clinical situation where patients receive ongoing low-dose (5 mg/day) prednisolone treatment, a dose by itself too low to cover glucocorticoid needs during stress.

DESIGN AND METHODS: Cross-sectional study in 42 patients with rheumatoid arthritis (29 women, aged 36-86 years) treated with 5 mg prednisolone/day, who had received prednisolone for ≥6 months (median: 66, range: 6-444 months). Adrenal function was evaluated by a 250 μg Synacthen test performed after mean 48.7 h prednisolone pause. Local assay-specific cut-off for normal adrenal function was P-cortisol ≥420 nmol/L 30 min after Synacthen injection.

RESULTS: Overall, 20 of the 42 patients (48%, 95% CI: 33-62%) had an insufficient adrenal response to the Synacthen test. Including only patients who had not received concomitant treatment with any other glucocorticoid formulas within the last 3 months, 13 of 33 patients (39%, 95% CI: 25-56%) had an insufficient response. Adrenocorticotrophic hormone (ACTH) concentrations were generally low and anti-adrenal antibodies were negative indicating secondary adrenal insufficiency as the most likely diagnosis. There was no correlation between duration of treatment and 30 min P-cortisol (P = 0.62). Adrenal function did not depend on sex or seropositivity of rheumatoid arthritis.

CONCLUSION: We demonstrate a high prevalence of adrenal insufficiency during ongoing low-dose prednisolone treatment. The results urge to increase focus on the condition to ensure identification and correct management of insufficient patients during stress and withdrawal. Strategies for adrenal function evaluation during ongoing low-dose glucocorticoid treatment need to be established.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Endocrinology
Vol/bind177
Udgave nummer4
Sider (fra-til)287-295
Antal sider9
ISSN0804-4643
DOI
StatusUdgivet - okt. 2017

ID: 52037884