Novel agents to treat adrenal insufficiency: findings of preclinical and early clinical trials
Expert Opin Investig Drugs. 2024 Jan 29:1-12. doi: 10.1080/13543784.2024.2311207. Online ahead of print.ABSTRACTINTRODUCTION: Adrenal insufficiency currently affects over 300/million population, with higher morbidity and mortality compared to the general population. Current glucocorticoid replacement therapy is limited by a lack of reliable biomarkers to guide dosing, inter-patient variation in metabolism and narrow therapeutic window. Increased morbidity and mortality may relate to unappreciated under- or over-exposure to glucocorticoids and impaired cortisol circadian rhythm. New agents are required to emulate physiologi...
Source: Expert Opinion on Investigational Drugs - January 29, 2024 Category: Drugs & Pharmacology Authors: Andrew Peel R Louise Rushworth David J Torpy Source Type: research
Mortality in patients with adrenal insufficiency: a protocol for a systematic review and meta-analysis
Introduction
Adrenal insufficiency (AI) is a rare disorder characterised by an impaired secretion of glucocorticoids from the adrenal glands. Treatment strategies for AI have developed over time with reduced glucocorticoid replacement doses and improved circadian exposure regimens, but whether this has resulted in better survival is unknown. The main purpose of this systematic review is to gather and synthesise available evidence on long-term mortality in patients with AI. The secondary aim is to study causes of death, with focus on cardiovascular and infectious diseases, in AI patients.
Methods and analysis
Studies publi...
Source: BMJ Open - January 29, 2024 Category: General Medicine Authors: Allosso, F., Dalakas, K., Bergthorsdottir, R., Chantzichristos, D., Hessman, E., Nwaru, B. I., Bobbio, E., Pasquali, D., Johannsson, G., Esposito, D. Tags: Open access, Diabetes and Endocrinology Source Type: research
Association of inflammatory bowel disease and autoimmune primary adrenal insufficiency
To assess the prevalence and association of inflammatory bowel disease (IBD) with autoimmune primary adrenal insufficiency (APAI). (Source: Gastroenterology)
Source: Gastroenterology - January 25, 2024 Category: Gastroenterology Authors: Salman Haider, Daryl Ramai, Saira Shah, Asad Ur Rahman, Moazzam Hussain, Iyad Al-Bustami, Praneeth Bandaru, Denzil Etienne Source Type: research
Comment on: Patient and operative factors influence delayed discharge following bariatric surgery in an enhanced recovery setting
Surg Obes Relat Dis. 2023 Dec 29:S1550-7289(23)00846-8. doi: 10.1016/j.soard.2023.12.012. Online ahead of print.NO ABSTRACTPMID:38272787 | DOI:10.1016/j.soard.2023.12.012 (Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery)
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - January 25, 2024 Category: Surgery Authors: Poppy Addison Source Type: research
Iatrogenic adrenal insufficiency in adults
Nature Reviews Endocrinology, Published online: 25 January 2024; doi:10.1038/s41574-023-00929-xIatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI. (Source: Nature Reviews Endocrinology)
Source: Nature Reviews Endocrinology - January 25, 2024 Category: Endocrinology Authors: Julie Martin-Grace Maria Tomkins Michael W. O ’Reilly Mark Sherlock Source Type: research
Lack of NAD(P)+ transhydrogenase activity in patients with primary adrenal insufficiency due to NNT variants
CONCLUSIONS: The manifestation of PAI in NNT-mutated patients is associated with a complete lack of NNT activity. Evaluation of NNT activity can be useful to characterize disease-causing NNT variants.PMID:38261461 | DOI:10.1093/ejendo/lvae011 (Source: European Journal of Endocrinology)
Source: European Journal of Endocrinology - January 23, 2024 Category: Endocrinology Authors: Annelise Francisco Ayse Mine Yilmaz Goler Claudia Daniele Carvalho Navarro Asan Onder Melek Yildiz Yasemin Kendir Demirkol Betul Karademir Yilmaz Tuba Seven Menevse T ülay Güran Roger Frig ério Castilho Source Type: research
Immune checkpoint inhibitor-induced isolated adrenocorticotropic hormone deficiency: a systematic review
ConclusionIAD was predominant in elderly male patients mainly receiving anti-PD-1 or anti-PD-L1 antibodies. It was sometimes difficult to recognize IAD at first glance since non-specific symptoms were common and asymptomatic cases of IAD were also reported. Although IAD can be deadly, it usually does not affect the continued use of ICIs. (Source: Frontiers in Endocrinology)
Source: Frontiers in Endocrinology - January 22, 2024 Category: Endocrinology Source Type: research
New onset of isolated adrenocorticotropin deficiency associated with encephalopathy following coronavirus disease 2019 in a healthy elderly man
We report the case of a 65-year-old Japanese man who developed isolated adrenocorticotropic hormone (ACTH) deficiency and encephalopathy following SARS-CoV-2 infection. Two weeks after his COVID-19 diagnosis, he was emergently admitted to our hospital because of subacute-onset delirium. On admission, he presented hyponatremia (128 mEq/L) and secondary adrenal insufficiency (ACTH <1.5 pg/mL, cortisol 0.53 μg/dL). Brain imaging and laboratory examinations including SARS-CoV-2 polymerase chain reaction testing in the cerebrospinal fluid revealed no abnormalities. His consciousness level worsened despite the amelioration o...
Source: Endocrine Journal - January 21, 2024 Category: Endocrinology Authors: Yusuke Yamasaki Ichiro Horie Riyoko Shigeno Shinpei Nishikido Toshiyuki Ikeoka Takuro Hirayama Yohei Tateishi Akira Tsujino Atsushi Kawakami Source Type: research
Recovery of adrenal function after stopping mitotane in patients with adrenocortical carcinoma
CONCLUSIONS: Our study demonstrates that adrenal recovery occurs in most patients after stopping mitotane, particularly when followed up in specialized centers, but not in all. Elimination time of mitotane after treatment discontinuation is very long but individually quite variable.PMID:38244214 | DOI:10.1093/ejendo/lvae007 (Source: European Journal of Endocrinology)
Source: European Journal of Endocrinology - January 20, 2024 Category: Endocrinology Authors: Barbara Altieri Otilia Kimpel Felix Megerle Mario Detomas Irina Chifu Carmina Teresa Fuss Marcus Quinkler Matthias Kroiss Martin Fassnacht Source Type: research
Clinical presentation and outcomes in patients with antiphospholipid syndrome-associated adrenal hemorrhage. A multicenter cohort study and systematic literature review
CONCLUSION: AH is a severe manifestation of APS with increased mortality. Most patients developed permanent primary adrenal insufficiency, particularly those positive for anticardiolipin IgG and bilateral adrenal involvement.PMID:38244823 | DOI:10.1016/j.clim.2024.109906 (Source: Clinical Immunology)
Source: Clinical Immunology - January 20, 2024 Category: Allergy & Immunology Authors: Jos é A Meade-Aguilar Gabriel Figueroa-Parra Jeffrey X Yang Hannah E Langenfeld Mariana Gonz ález-Treviño Prerna Dogra Irina Bancos Michael R Moynagh M Hassan Murad Larry J Prokop Andrew C Hanson Cynthia S Crowson Al í Duarte-García Source Type: research
Extensive Expertise in Endocrinology: Adrenal crisis in assisted reproduction and pregnancy
Eur J Endocrinol. 2024 Jan 18:lvae005. doi: 10.1093/ejendo/lvae005. Online ahead of print.ABSTRACTAppropriate management of adrenal insufficiency in pregnancy is challenging due to the rarity of both primary, secondary and tertiary forms of the disease as well as the lack of evidence-based recommendations to guide clinicians to glucocorticoid and sometimes also mineralocorticoid dosage adjustments. Debut of adrenal insufficiency during pregnancy requires immediate diagnosis as it can lead to adrenal crisis, intrauterine growth restriction and foetal demise. Diagnosis is difficult due to overlap of symptoms of adrenal insuf...
Source: European Journal of Endocrinology - January 19, 2024 Category: Endocrinology Authors: Ulla Feldt-Rasmussen Source Type: research
Posaconazole-induced primary adrenal insufficiency: A rare but real risk
This report presents two patients with hematologic malignancies who developed primary glucocorticoid deficiency due to posaconazole. Both received allogeneic stem-cell transplantation and used posaconazole as antifungal prophylaxis. Both patients had low morning cortisol and elevated ACTH levels, which suggested primary adrenal insufficiency. Posaconazole, widely used for antifungal prophylaxis and long-term therapy, undoubtedly affects adrenal steroid synthesis. Thus, healthcare providers must be aware of that posaconazole may cause adrenal insufficiency, and should monitor patients taking this medication.PMID:38242202 | ...
Source: Annales d'Endocrinologie - January 19, 2024 Category: Endocrinology Authors: Antonia Precali Pavle Roncevic Ivana Kraljevic Source Type: research
Androgen deficiency in hypopituitary women: its consequences and management
Rev Endocr Metab Disord. 2024 Jan 19. doi: 10.1007/s11154-024-09873-1. Online ahead of print.ABSTRACTWomen with hypopituitarism have various degrees of androgen deficiency, which is marked among those with combined hypogonadotrophic hypogonadism and secondary adrenal insufficiency. The consequences of androgen deficiency and the effects of androgen replacement therapy have not been fully elucidated. While an impact of androgen deficiency on outcomes such as bone mineral density, quality of life, and sexual function is plausible, the available evidence is limited. There is currently no consensus on the definition of androge...
Source: ENDOCR REV - January 19, 2024 Category: Endocrinology Authors: Daniela Esposito Åsa Tivesten Catharina Olivius Oskar Ragnarsson Gudmundur Johannsson Source Type: research
Androgen deficiency in hypopituitary women: its consequences and management
AbstractWomen with hypopituitarism have various degrees of androgen deficiency, which is marked among those with combined hypogonadotrophic hypogonadism and secondary adrenal insufficiency. The consequences of androgen deficiency and the effects of androgen replacement therapy have not been fully elucidated. While an impact of androgen deficiency on outcomes such as bone mineral density, quality of life, and sexual function is plausible, the available evidence is limited. There is currently no consensus on the definition of androgen deficiency in women and it is still controversial whether androgen substitution should be u...
Source: Reviews in Endocrine and Metabolic Disorders - January 19, 2024 Category: Endocrinology Source Type: research
Basal cortisol in relation to metyrapone confirmation in predicting adrenal insufficiency after pituitary surgery
ConclusionEarly morning plasma cortisol cut-off values lower than 450 nmol/L can safely be used to guide the need for hydrocortisone replacement after pituitary surgery. (Source: Pituitary)
Source: Pituitary - January 19, 2024 Category: Endocrinology Source Type: research
