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Prospective evaluation of long-term safety of dual-release hydrocortisone replacement administered once daily in patients with adrenal insufficiency
Department of Endocrinology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Medical Affairs, ViroPharma SPRL, Maidenhead, UK,.
Biostatistics, ViroPharma Incorporated, Skånes University Hospital, Malmö, Sweden.
Department of Endocrinology, Skånes University Hospital, Malmö, Sweden.
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2014 (English)In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 171, no 3, p. 369-377Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective was to assess the long-term safety profile of dual-release hydrocortisone (DR-HC) in patients with adrenal insufficiency (AI). DESIGN: Randomised, open-label, crossover trial of DR-HC or thrice-daily hydrocortisone for 3 months each (stage 1) followed by two consecutive, prospective, open-label studies of DR-HC for 6 months (stage 2) and 18 months (stage 3) at five university clinics in Sweden.

METHODS: Sixty-four adults with primary AI started stage 1, and an additional 16 entered stage 3. Patients received DR-HC 20-40 mg once daily and hydrocortisone 20-40 mg divided into three daily doses (stage 1 only). Main outcome measures were adverse events (AEs) and intercurrent illness (self-reported hydrocortisone use during illness).

RESULTS: In stage 1, patients had a median 1.5 (range, 1-9) intercurrent illness events with DR-HC and 1.0 (1-8) with thrice-daily hydrocortisone. AEs during stage 1 were not related to the cortisol exposure-time profile. The percentage of patients with one or more AEs during stage 1 (73.4% with DR-HC; 65.6% with thrice-daily hydrocortisone) decreased during stage 2, when all patients received DR-HC (51% in the first 3 months; 54% in the second 3 months). In stages 1-3 combined, 19 patients experienced 27 serious AEs, equating to 18.6 serious AEs/100 patient-years of DR-HC exposure.

CONCLUSIONS: This long-term prospective trial is the first to document the safety of DR-HC in patients with primary AI and demonstrates that such treatment is well tolerated during 24 consecutive months of therapy.

Place, publisher, year, edition, pages
Bioscientifica, 2014. Vol. 171, no 3, p. 369-377
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-110418DOI: 10.1530/EJE-14-0327ISI: 000343670900015PubMedID: 24944332Scopus ID: 2-s2.0-84907206929OAI: oai:DiVA.org:oru-110418DiVA, id: diva2:1820584
Note

Funding Agency:

ViroPharma SPRL, Maidenhead, UK

Available from: 2023-12-18 Created: 2023-12-18 Last updated: 2023-12-20Bibliographically approved

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Wahlberg, Jeanette

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