title: [Corticotherapy withdrawal in older people].
abstract: Synthetic glucocorticoids treatment for their antiinflammatory and immunosuppressive activities for more than 3 weeks decreases corticotropic axis and induces a risk of adrenal insufficiency upon treatment withdrawal. Dose, duration and unknown individual factors play a role in the occurrence of adrenal insufficiency. Serum cortisol at 7-8 am, possibly completed by an 1-24 ACTH stimulation test makes the diagnosis. A scheme for care of patients is included with a progressive decrease of synthetic glucocorticoids dose, a replacement of this medication with physiological doses of hydrocortisone (in case of adrenal insufficiency) and a follow-up of endogenous secretion for detection of adrenal function recovery.
authors: Pôle gériatrique, Centre gérontologique départemental, Marseille, France, EA3279, Évaluation des systèmes de soins - Santé perçue, Faculté de médecine, Aix Marseille Université, Marseille, France.
authors: Frédérique
authors: F
authors: Retornaz
authors: Service d'endocrinologie, Hôpital Nord, Assistance publique des hôpitaux de Marseille, France.
authors: Sandrine
authors: S
authors: Boullu-Ciocca
authors: Pôle gériatrique, Centre gérontologique départemental, Marseille, France.
authors: Anaïs
authors: A
authors: Farcet
authors: Pôle gériatrique, Centre gérontologique départemental, Marseille, France.
authors: Charles
authors: C
authors: Oliver
mesh_terms: D000309:Adrenal Insufficiency / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D000368:Aged; D000465:Algorithms; D002940:Circadian Rhythm; D003366:Cosyntropin; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D013375:Substance Withdrawal Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology*
chemical_list: D005938:Glucocorticoids; D003366:Cosyntropin; D006854:Hydrocortisone
keywords: ACTH 1-24 stimulation test; adrenal insufficiency; glucocorticoid therapy; hydrocortisone; serum cortisol