What question did this study set out to answer?

To assess the adequacy of glucocorticoid replacement regimens in hypoadrenal patients and evaluate how dose optimization affects bone formation and resorption markers.

March 1, 1997Clinical Endocrinology

Glucocorticoid replacement therapy: are patients over treated and does it matter?

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Authors

SPSteven R. PeaceyBradford Teaching Hospitals NHS Foundation Trust CGChunyuan GuoTongji University ARAnthony M. RobinsonWashington University in St. Louis

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Implication

Prospective study reveals frequent glucocorticoid overtreatment in hypoadrenal patients, indicating dose reduction improves bone formation.

Key Points

To assess the adequacy of glucocorticoid replacement regimens in hypoadrenal patients and evaluate how dose optimization affects bone formation and resorption markers.
Assessed 32 consecutive outpatients receiving glucocorticoid replacement (12 with Addison's disease and 20 with hypopituitarism) at a university hospital.
Correlated serum cortisol day curves with 24-hour urine free cortisol excretion to identify overtreatment and guide hydrocortisone dose reduction.
Measured osteocalcin, urinary N-telopeptide of type I collagen (NTX), and bone mineral density before and after prospective dose alteration.
Therapy changes were required in 28/32 (88%) patients, with 24/32 (75%) requiring a dose reduction; mean hydrocortisone dose decreased from 29.5 ± 1.2 to 20.8 ± 1.0 mg/day.
Peak serum cortisol correlated significantly with 24-hour urine free cortisol/creatinine ratio (Spearman r = 0.60, P < 0.0001; n = 51).
Following hydrocortisone dose reduction, median osteocalcin increased from 16.7 µg/L (range 8.2–65.7) to 19.9 µg/L (range 8.2–56.3; P < 0.01), with no significant change in urinary NTX/creatinine.

Cite This Study

Peacey et al. (1997) studied this question.

synapsesocial.com/papers/6a70d952a2d7cf2e39c2b97a https://doi.org/10.1046/j.1365-2265.1997.780907.x

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Implication

Prospective study reveals frequent glucocorticoid overtreatment in hypoadrenal patients, indicating dose reduction improves bone formation.

Glucocorticoid replacement therapy: are patients over treated and does it matter?

Discussion

Member takes

Implication

Key Points

Cite This Study

Glucocorticoid replacement therapy: are patients over treated and does it matter?

Discussion

Member takes

Implication

Key Points

Cite This Study

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