title: Modified-release prednisone decreases complaints and fatigue compared to standard prednisolone in patients with adrenal insufficiency.
abstract: Patients with adrenal insufficiency (AI) receive first glucocorticoid replacement dose after waking, resulting in a 3-5 h delay compared to physiological secretion. Impaired quality of life (QoL) and fatigue might be due to this delayed dose scheme. Modified-release glucocorticoid preparations might have therapeutic advantages. Exploratory pilot study including 14 patients with AI was conducted in a single university center. Patients on morning dose prednisolone (5 mg) were included, switched to modified-release prednisone (5 mg) at 10 PM for 3 months, and then switched back on standard prednisolone. 3 standardized questionnaires (GBB-24, MFI, and AddiQoL) investigating complaints and fatigue were completed at baseline, after 3, and 6 months. Data regarding clinical and hormonal parameters were assessed. Modified-release prednisone showed significant improvement in one of 4 scales of GBB-24 and positive trends to better scores in 3 of 4 scales. The global score of discomfort improved significantly. The MFI showed also significant improvement in 3 of 5 scales and positive trend to better scores in 2 scales. Significant changes to better scores were seen in 4 out of 30 items of the AddiQoL. Modified-release prednisone showed decreased complaints and fatigue compared to standard prednisolone indicating importance of glucocorticoid increase in early morning hours before waking.
authors: Department of Clinical Endocrinology, Charité Campus Mitte, Charité University Medicine Berlin, Berlin, Germany.
authors: J
authors: J
authors: Langenheim
authors: M
authors: M
authors: Ventz
authors: A
authors: A
authors: Hinz
authors: M
authors: M
authors: Quinkler
mesh_terms: D000224:Addison Disease / Q000188:drug therapy / Q000503:physiopathology; D000309:Adrenal Insufficiency / Q000188:drug therapy* / Q000503:physiopathology; D000368:Aged; D002940:Circadian Rhythm; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010865:Pilot Projects; D011241:Prednisone / Q000008:administration & dosage* / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D003692:Delayed-Action Preparations; D005938:Glucocorticoids; D011241:Prednisone