Modified-release hydrocortisone decreases BMI and HbA1c in patients with primary and secondary adrenal insufficiency

Quinkler, Marcus; Nilsen, Roy Miodini; Zopf, Kathrin; Ventz, Manfred; Øksnes, Marianne

doi:10.1530/eje-14-1114

Cited by 115 publications

(119 citation statements)

References 25 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…In an open prospective study in a single center, on 50 patients treated with hydrocortisone, 30 patients showed a benefit with replacement by Plenadren ® after a mean duration of 6 months, with a significant reduction in BMI and HbA1c, compared to patients treated with classical hydrocortisone. The Plenadren ® treated patients also showed no change in quality of life measures while the patients on classical hydrocortisone treatment showed a reduction in quality of life [38]. These results confirm those of a prospective randomized pilot study published in 2012, on 64 patients who benefitted from a crossover from hydrocortisone to Plenadren ® .…”

Section: New Moleculessupporting

confidence: 75%

Group 4: Replacement therapy for adrenal insufficiency

Castinetti

Guignat

Bouvattier

et al. 2017

Annales d'Endocrinologie

View full text Add to dashboard Cite

Section: New Moleculessupporting

confidence: 75%

Group 4: Replacement therapy for adrenal insufficiency

Castinetti

Guignat

Bouvattier

et al. 2017

Annales d'Endocrinologie

View full text Add to dashboard Cite

“…In addition, advantages other than patient convenience have not been robustly demonstrated to date. However, data are steadily accumulating to support improved metabolic outcomes 31,32 and the use of Plenadren® is likely to increase. An additional product, Chronocort®, containing microparticulate hydrocortisone with delayed absorption, is also currently in development.…”

Section: New Developmentsmentioning

confidence: 99%

Adrenal insufficiency – recognition and management

Pazderska

Pearce

2017

Clinical Medicine

View full text Add to dashboard Cite

Adrenal insuffi ciency is characterised by inadequate glucocorticoid production owing to destruction of the adrenal cortex or lack of adrenocorticotropic hormone stimulation. In primary adrenal insuffi ciency, lack of mineralocorticoids is also a feature. Patients can present with an insidious onset of symptoms, or acutely in adrenal crisis, which requires prompt recognition and treatment. Chronic glucocorticoid therapy is the most common cause of adrenal insuffi ciency. The diagnosis of adrenal insuffi ciency is made by demonstrating low basal and/or stimulated serum cortisol and should be followed by appropriate investigations to establish the underlying aetiology. Maintenance glucocorticoid replacement is usually given as a twice or thrice daily hydrocortisone preparation. Patients with primary adrenal insuffi ciency also require mineralocorticoid. Regular monitoring for features of underand over-replacement is essential during follow-up. Patient education is a key feature of management of this condition. IntroductionThe adrenal cortex secretes the essential steroid hormones, cortisol and aldosterone, under the control of pituitary adrenocorticotropic hormone (ACTH), angiotensin II and plasma potassium. The most frequent cause of adrenal insufficiency is exogenous steroid use. Up to 2.5% of the population are taking such steroid medications for inflammatory or immune-mediated conditions. 1 These individuals are vulnerable to steroid deficiency if the medication is stopped suddenly. ACTH deficiency (secondary adrenal insufficiency) as a result of pituitary tumours, infiltrative diseases, head injury or congenital hypopituitarism is the next most frequent cause, present in around 1 per 3,000 individuals. 2High dose opiates, which frequently induce hypogonadotropic hypogonadism, are also increasingly recognised as a cause of hypothalamic-pituitary-adrenal (HPA) suppression.3 By comparison, primary adrenal insufficiency is rare, with a prevalence of 1 in 8,000 people. 4 In developed nations, an autoimmune attack directed against the adrenal steroidogenic enzymes (predominantly 21-hydroxylase) 5 accounts for about 85% of cases. Around 60% of patients with autoimmune ABSTRACT Adrenal insuffi ciency -recognition and managementAddison's disease have an additional autoimmune condition, most frequently autoimmune thyroid disease or type 1 diabetes.

show abstract

“…Recently, the disease-specific questionnaire AddiQoL was developed (40) and validated (41) as an evaluative tool in PAI, which might facilitate the detection of minor changes in well-being in future clinical trials and during routine follow-up of patients (42,43,44,45).…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

“…It is, however, likely that lack of night-time cortisol in patients on regular glucocorticoid replacement therapy confers risk of nocturnal hypoglycaemia, which may be a problem particular to patients with concomitant diabetes mellitus (84). Use of once-daily modified release hydrocortisone tablet (Plenadren, Viropharma Inc, Exton, PA, USA) resulted in decreased body mass index (BMI) and HbA1c compared with conventional hydrocortisone treatment (43,85). Possibly, these findings were due to a beneficial reduction in 24-h hydrocortisone exposure, especially evident in the afternoon (85,86).…”

Section: Metabolismmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Epidemiology, quality of life and complications of primary adrenal insufficiency: a review

Bensing

Hulting

Husebye

et al. 2016

European Journal of Endocrinology

View full text Add to dashboard Cite

In this article, we review published studies covering epidemiology, natural course and mortality in primary adrenal insufficiency (PAI) or Addison's disease. Autoimmune PAI is a rare disease with a prevalence of 100-220 per million inhabitants. It occurs as part of an autoimmune polyendocrine syndrome in more than half of the cases. The patients experience impaired quality of life, reduced parity and increased risk of preterm delivery. Following a conventional glucocorticoid replacement regimen leads to a reduction in bone mineral density and an increase in the prevalence of fractures. Registry studies indicate increased mortality, especially evident in patients diagnosed with PAI at a young age and in patients with the rare disease autoimmune polyendocrine syndrome type-1. Most notably, unnecessary deaths still occur because of adrenal crises. All these data imply the need to improve the therapy and care of patients with PAI.

show abstract

Modified-release hydrocortisone decreases BMI and HbA1c in patients with primary and secondary adrenal insufficiency

Cited by 115 publications

References 25 publications

Group 4: Replacement therapy for adrenal insufficiency

Group 4: Replacement therapy for adrenal insufficiency

Adrenal insufficiency – recognition and management

MANAGEMENT OF ENDOCRINE DISEASE: Epidemiology, quality of life and complications of primary adrenal insufficiency: a review

Contact Info

Product

Resources

About