Management of glucocorticoid replacement in adrenal insufficiency shows notable heterogeneity - data from the EU-AIR

• DOI: 10.1111/cen.13267
• Publication Date: 2016-12-05T10:53:22Z
• Authors: Robert D. Murray; Bertil Ekman; Sharif Uddin; Claudio Marelli; Marcus Quinkler; Pierre M.J. Zelissen
• Keywords: Regimen; Primary Adrenal Insufficiency

Context and objective Treatment for adrenal insufficiency (AI) remains suboptimal. Despite glucocorticoid replacement, patients with AI have reduced life expectancy quality of life. This study aimed to describe the spectrum management replacement in enrolled European Adrenal Insufficiency Registry (EU-AIR). Design, setting EU-AIR is a prospective, multinational, multicentre, observational initiated August 2012 monitor long-term safety routine clinical practice Germany, Netherlands, Sweden UK (ClinicalTrials.gov identifier: NCT01661387). analysis included 1166 primary secondary (mean disease duration 16·1 ± 11·6 years) receiving therapy. Main outcome measure Glucocorticoid type, dose, frequency treatment regimen were examined. Results Most (87·4%) hydrocortisone. The most common dose range, taken by 42·2% patients, was 20 <25 mg/day; however, 12·6% doses ≥30 mg/day. Hydrocortisone being once daily 5·5%, twice 48·7%, three times 43·6% four 2·1%. Patients received higher than those (23·4 8·9 19·6 5·9 mg/day, respectively). Twenty-five different regimens used deliver hydrocortisone mg. Conclusions We shown significant heterogeneity timing real-world practice. reflects individualization based on patient symptoms lifestyle absence data supporting optimal regimen.