Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis
Nowotny, Hanna (Klinikum der Universität München)
Ahmed, S. Faisal (University of Glasgow)
Bensing, Sophie (Karolinska University Hospital and Karolinska Institutet (Suècia))
Beun, Johan G. (AdrenalNET (Holanda))
Brösamle, Manuela (University Hospital of Würzburg)
Claahsen van der Grinten, Hedi (Radboud University Medical Centre)
Clemente, Maria (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Falhammar, Henrik (Karolinska University Hospital and Karolinska Institutet (Suècia))
Hahner, Stefanie (University Hospital of Würzburg)
Husebye, Eystein Sverre (Haukeland University Hospital (Bergen, Noruega))
Kristensen, Jette (European Patient Advocacy Group for Adrenal Diseases (Holanda))
Loli, Paola (San Raffaele Vita-Salute University)
Lajic, Svetlana (Karolinska University Hospital and Karolinska Institutet (Suècia))
Reisch, Nicole (Klinikum der Universität München)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Adrenal insufficiency (AI) is a life-threatening condition requiring life-long glucocorticoid (GC) substitution therapy, as well as stress adaptation to prevent adrenal crises. The number of individuals with primary and secondary adrenal insufficiency in Europe is estimated to be 20-50/100. 000. A growing number of AI cases are due to side effects of GC treatment used in different treatment strategies for cancer and to immunotherapy in cancer treatment. The benefit of hormone replacement therapy is evident but long-term adverse effects may arise due to the non-physiological GC doses and treatment regimens used. Given multiple GC replacement formulations available comprising short-acting, intermediate, long-acting and novel modified-release hydrocortisone as well as subcutaneous formulations, this review offers a concise summary on the latest therapeutic improvements for treatment of AI and prevention of adrenal crises. As availability of various glucocorticoid formulations and access to expert centers across Europe varies widely, European Reference Networks on rare endocrine conditions aim at harmonizing treatment and ensure access to specialized patient care for individual case-by-case treatment decisions. To improve the availability across Europe to cost effective oral and parenteral formulations of hydrocortisone will save lives.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Adrenal insufficiency ; Congenital adrenal hyperplasia ; Adrenal crisis ; Glucocorticoid replacement ; Hydrocortisone ; Stress instructions
Published in:	Endocrine, march 2021, p. 1-9, ISSN 1559-0100

DOI: 10.1007/s12020-021-02649-6
PMID: 33661460

9 p, 817.8 KB

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