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Horm Metab Res 2013; 45(02): 96-101
DOI: 10.1055/s-0032-1316293
Humans, Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Modified-Release Prednisone Decreases Complaints and Fatigue Compared to Standard Prednisolone in Patients with Adrenal Insufficiency

J. Langenheim
1   Department of Clinical Endocrinology, Charité Campus Mitte, Charité University Medicine Berlin, Berlin, Germany
,
M. Ventz
1   Department of Clinical Endocrinology, Charité Campus Mitte, Charité University Medicine Berlin, Berlin, Germany
,
A. Hinz
2   Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
,
M. Quinkler
1   Department of Clinical Endocrinology, Charité Campus Mitte, Charité University Medicine Berlin, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 19 April 2012

accepted 22 May 2012

Publication Date:
29 June 2012 (online)

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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.

Key words

glucocorticoid replacement therapy - Addison’s disease - cortisol circadian rhythm - GBB-24 - MFI - AddiQoL
 

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