European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency.

{"article_title":"European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency.","author":"\"Beuschlein, Felix , Else, Tobias , Bancos, Irina , Hahner, Stefanie , Hamidi, Oksana , van Hulsteijn, Leonie , Husebye, Eystein S , Karavitaki, Niki , Prete, Alessandro , Vaidya, Anand , Yedinak, Christine , Dekkers, Olaf M\"","journal_title":"European journal of endocrinology","issn":"1479-683X ; Electronic","isbn":"","publication_date":"20240502","volume":"190","issue":"5","first_page":"G25","page_count":"","accession_number":"38714321","doi":"10.1093\/ejendo\/lvae029","publisher":"Oxford University Press","doctype":"Journal Article; Practice Guideline","subjects":"Endocrinology","interest_area":["Endocrinology"," Internal\/Family Medicine"],"abstract":"Glucocorticoids are widely prescribed as anti-inflammatory and immunosuppressive agents. This results in at least 1% of the population using chronic glucocorticoid therapy, being at risk for glucocorticoid-induced adrenal insufficiency. This risk is dependent on the dose, duration and potency of the glucocorticoid, route of administration, and individual susceptibility. Once glucocorticoid-induced adrenal insufficiency develops or is suspected, it necessitates careful education and management of affected patients. Tapering glucocorticoids can be challenging when symptoms of glucocorticoid withdrawal develop, which overlap with those of adrenal insufficiency. In general, tapering of glucocorticoids can be more rapidly within a supraphysiological range, followed by a slower taper when on physiological glucocorticoid dosing. The degree and persistence of HPA axis suppression after cessation of glucocorticoid therapy are dependent on overall exposure and recovery of adrenal function varies greatly amongst individuals. This first European Society of Endocrinology\/Endocrine Society joint clinical practice guideline provides guidance on this clinically relevant condition to aid clinicians involved in the care of patients on chronic glucocorticoid therapy.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=38714321&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Beuschlein F, Else T, Bancos I, Hahner S, Hamidi O, van Hulsteijn L, Husebye ES, Karavitaki N, Prete A, Vaidya A, Yedinak C, Dekkers OM","Journal_Info":"Publisher: Oxford University Press Country of Publication: England NLM ID: 9423848 Publication Model: Print Cited Medium: Internet ISSN: 1479-683X (Electronic) Linking ISSN: 08044643 NLM ISO Abbreviation: Eur J Endocrinol Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline","Published_Date":"2024-05-02","Source":"European journal of endocrinology [Eur J Endocrinol] 2024 May 02; Vol. 190 (5), pp. G25-G51.","Languages":"English","Electronic_ISSN":"1479-683X","MeSH_Terms":"Glucocorticoids*\/adverse effects , Glucocorticoids*\/therapeutic use , Glucocorticoids*\/administration & dosage , Adrenal Insufficiency*\/diagnosis , Adrenal Insufficiency*\/chemically induced , Adrenal Insufficiency*\/therapy , Adrenal Insufficiency*\/drug therapy , Endocrinology*\/standards , Endocrinology*\/methods, Humans ; Europe ; Societies, Medical\/standards","Subjects":"Humans, Europe, Societies, Medical standards, Glucocorticoids adverse effects, Glucocorticoids therapeutic use, Glucocorticoids administration & dosage, Adrenal Insufficiency diagnosis, Adrenal Insufficiency chemically induced, Adrenal Insufficiency therapy, Adrenal Insufficiency drug therapy, Endocrinology standards, Endocrinology methods","Title_Abbreviations":"European journal of endocrinology","Volume":"190"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"38714321","RelevancyScore":"914","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"914.459899902344"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=38714321&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=38714321&authtype=shib&custid=ns346513&group=main&profile=eds"}