scholarly journals Corticosteroid Replacement Therapy

2021 ◽  
Author(s):  
Michael C. Onyema
Keyword(s):  
Clinical Trials ◽  
Adrenal Insufficiency ◽  
Replacement Therapy ◽  
20Th Century ◽  
Hormone Replacement ◽  
Modified Release ◽  
Future Treatment ◽  
Release Drug ◽  
Treatment Considerations ◽  
Special Circumstances

The advent of synthetic corticosteroids in the 20th century provided a vital breakthrough in the management of adrenal insufficiency. In this chapter we review the main indications and guidance for appropriate hormone replacement and also look into the management of therapy during special circumstances. For decades hydrocortisone has remained the cornerstone for glucocorticoid replacement but we explore the alternatives including recently introduced modified-release drug preparations and the future treatment considerations currently undergoing research and pre-clinical trials.

scholarly journals Beneficial effects of replacement therapy with modified-release hydrocortisone in patients with adrenal insufficiency

2015 ◽  
Author(s):  
Valentina Morelli ◽  
Erika Messina ◽  
Marco Mendola ◽  
Elisa Cairoli ◽  
Bruno Ambrosi ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Replacement Therapy ◽  
Modified Release ◽  
Beneficial Effects

scholarly journals Prednisolone is associated with a worse bone mineral density in primary adrenal insufficiency

2018 ◽  
Vol 7 (6) ◽  
pp. 811-818 ◽  
Author(s):  
Kathrin R Frey ◽  
Tina Kienitz ◽  
Julia Schulz ◽  
Manfred Ventz ◽  
Kathrin Zopf ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Adrenal Insufficiency ◽  
Replacement Therapy ◽  
Bone Mineral ◽  
Immediate Release ◽  
Modified Release ◽  
Mineral Density ◽  
Primary Adrenal Insufficiency ◽  
Z Scores

Context Patients with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) therapy. Daily GC doses are often above the physiological cortisol production rate and can cause long-term morbidities such as osteoporosis. No prospective trial has investigated the long-term effect of different GC therapies on bone mineral density (BMD) in those patients. Objectives To determine if patients on hydrocortisone (HC) or prednisolone show changes in BMD after follow-up of 5.5 years. To investigate if BMD is altered after switching from immediate- to modified-release HC. Design and patients Prospective, observational, longitudinal study with evaluation of BMD by DXA at visit1, after 2.2 ± 0.4 (visit2) and after 5.5 ± 0.8 years (visit3) included 36 PAI and 8 CAH patients. Thirteen patients received prednisolone (age 52.5 ± 14.8 years; 8 women) and 31 patients received immediate-release HC (age 48.9 ± 15.8 years; 22 women). Twelve patients on immediate-release switched to modified-release HC at visit2. Results Prednisolone showed significantly lower Z-scores compared to HC at femoral neck (−0.85 ± 0.80 vs −0.25 ± 1.16, P < 0.05), trochanter (−0.96 ± 0.62 vs 0.51 ± 1.07, P < 0.05) and total hip (−0.78 ± 0.55 vs 0.36 ± 1.04, P < 0.05), but not at lumbar spine, throughout the study. Prednisolone dose decreased by 8% over study time, but no significant effect was seen on BMD. BMD did not change significantly after switching from immediate- to modified-release HC. Conclusions The use of prednisolone as hormone replacement therapy results in significantly lower BMD compared to HC. Patients on low-dose HC replacement therapy showed unchanged Z-scores within the normal reference range during the study period.

scholarly journals The impact of clinical trials on the use of hormone replacement therapy

2005 ◽  
Vol 20 (11) ◽  
pp. 1026-1031 ◽  
Author(s):  
Nancy Kim ◽  
Cary Gross ◽  
Jeptha Curtis ◽  
Glen Stettin ◽  
Stephen Wogen ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
The Impact
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