Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement
Introduction: Patients who need glucocorticoid replacement in both primary and secondary adrenal insufficiency (AI) have the choice of either once-daily prednisolone or thrice-daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several m...
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Bioscientifica
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doaj-49c6558e105b4c27ac5b069ee999d2412020-11-24T21:41:06ZengBioscientificaEndocrine Connections2049-36142049-36142017-10-016876677210.1530/EC-17-0257Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacementDavid J F Smith0Hemanth Prabhudev1Sirazum Choudhury2Karim Meeran3Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UKDepartment of Endocrinology, Imperial College Healthcare NHS Trust, London, UKDepartment of Endocrinology, Imperial College Healthcare NHS Trust, London, UK; Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK; Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UKDepartment of Endocrinology, Imperial College Healthcare NHS Trust, London, UK; Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UKIntroduction: Patients who need glucocorticoid replacement in both primary and secondary adrenal insufficiency (AI) have the choice of either once-daily prednisolone or thrice-daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers including glucose, weight, body mass index, systolic and diastolic blood pressure and waist circumference, although an increase in cholesterol and low-density lipoprotein (LDL) was suggested in a subgroup of these patients. The aim of this study was to expand the evidence base for the use of these agents as replacement therapy. Methods: Data from 82 patients on hydrocortisone and 64 patients on prednisolone for AI at Imperial College Healthcare NHS Trust were analysed. Results: There was no significant difference in total cholesterol, LDL levels or any other risk factors between hydrocortisone and prednisolone patients. Prednisolone was subjectively significantly more convenient than hydrocortisone (P = 0.048). Conclusions: Prednisolone once daily is more convenient than hydrocortisone thrice daily, and there is no difference in the markers of cardiovascular risk measured. Because prednisolone mimics the circadian rhythm better than other glucocorticoids, it should be considered as an alternative to hydrocortisone for AI.http://www.endocrineconnections.com/content/6/8/766.fullprednisolonehydrocortisoneadrenal insufficiencycardiovascular risk |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David J F Smith Hemanth Prabhudev Sirazum Choudhury Karim Meeran |
spellingShingle |
David J F Smith Hemanth Prabhudev Sirazum Choudhury Karim Meeran Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement Endocrine Connections prednisolone hydrocortisone adrenal insufficiency cardiovascular risk |
author_facet |
David J F Smith Hemanth Prabhudev Sirazum Choudhury Karim Meeran |
author_sort |
David J F Smith |
title |
Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
title_short |
Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
title_full |
Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
title_fullStr |
Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
title_full_unstemmed |
Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
title_sort |
prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement |
publisher |
Bioscientifica |
series |
Endocrine Connections |
issn |
2049-3614 2049-3614 |
publishDate |
2017-10-01 |
description |
Introduction: Patients who need glucocorticoid replacement in both primary and secondary adrenal insufficiency (AI) have the choice of either once-daily prednisolone or thrice-daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers including glucose, weight, body mass index, systolic and diastolic blood pressure and waist circumference, although an increase in cholesterol and low-density lipoprotein (LDL) was suggested in a subgroup of these patients. The aim of this study was to expand the evidence base for the use of these agents as replacement therapy.
Methods: Data from 82 patients on hydrocortisone and 64 patients on prednisolone for AI at Imperial College Healthcare NHS Trust were analysed.
Results: There was no significant difference in total cholesterol, LDL levels or any other risk factors between hydrocortisone and prednisolone patients. Prednisolone was subjectively significantly more convenient than hydrocortisone (P = 0.048).
Conclusions: Prednisolone once daily is more convenient than hydrocortisone thrice daily, and there is no difference in the markers of cardiovascular risk measured. Because prednisolone mimics the circadian rhythm better than other glucocorticoids, it should be considered as an alternative to hydrocortisone for AI. |
topic |
prednisolone hydrocortisone adrenal insufficiency cardiovascular risk |
url |
http://www.endocrineconnections.com/content/6/8/766.full |
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