Trial reportThe Journal of clinical endocrinology and metabolism2020
Residual Corticosteroid Production in Autoimmune Addison Disease.
Trial report in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Health-related quality of life and patterns of psychological vulnerability in autoimmune Addison's disease: a systematic review.Frontiers in endocrinology · 2026Pooled it
- Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: an ESE clinical practice guideline.European journal of endocrinology · 2022Guideline
- Cognitive Assessment in Adults With Adrenal Cortisol Insufficiency: Challenges and Opportunities.Endocrine reviews · 2026Review
- Multiple Endocrinology Immune-Related Adverse Events (irAEs) Related to Pembrolizumab as Neoadjuvant Treatment in Two Cases of TNBC Patients: Case Reports and Literature Review.Current oncology (Toronto, Ont.) · 2026Review
- Mineralocorticoid effects of fludrocortisone and hydrocortisone in primary adrenal insufficiency: EU-AIR patient data.Journal of endocrinological investigation · 2025Observational
- Aire Mutations and Autoimmune Diseases.Advances in experimental medicine and biology · 2025Review
- Plasma Renin: A Useful Marker for Mineralocorticoid Adjustment in Patients With Primary Adrenal Insufficiency.Journal of the Endocrine Society · 2024Article
- A Contemporary Approach to the Diagnosis and Management of Adrenal Insufficiency.Endocrinology and metabolism (Seoul, Korea) · 2024Review
- Approach to the Patient: Diagnosis of Primary Adrenal Insufficiency in Adults.The Journal of clinical endocrinology and metabolism · 2023Article
- Plasma-Metanephrines in Patients with Autoimmune Addison's Disease with and without Residual Adrenocortical Function.Journal of clinical medicine · 2023Article
- Autoimmune primary adrenal insufficiency -current diagnostic approaches and future perspectives.Frontiers in endocrinology · 2023Review
- Heterogeneous natural history of Addison's disease: mineralocorticoid deficiency may predominate.Endocrine connections · 2023Article
- Observational
- The natural history of 21-hydroxylase autoantibodies in autoimmune Addison's disease.European journal of endocrinology · 2021Article
- Potential Transcriptional Biomarkers to Guide Glucocorticoid Replacement in Autoimmune Addison's Disease.Journal of the Endocrine Society · 2021Article
- Latent Adrenal Insufficiency: From Concept to Diagnosis.Frontiers in endocrinology · 2021Review
Corrections and comments
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Authors and funding
26 authors at 16 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextContrary to current dogma, growing evidence suggests that some patients with autoimmune Addison disease (AAD) produce corticosteroids even years after diagnosis.
objectiveTo determine frequencies and clinical features of residual corticosteroid production in patients with AAD.
designTwo-staged, cross-sectional clinical study in 17 centers (Norway, Sweden, and Germany). Residual glucocorticoid (GC) production was defined as quantifiable serum cortisol and 11-deoxycortisol and residual mineralocorticoid (MC) production as quantifiable serum aldosterone and corticosterone after > 18 hours of medication fasting. Corticosteroids were analyzed by liquid chromatography-tandem mass spectrometry. Clinical variables included frequency of adrenal crises and quality of life. Peak cortisol response was evaluated by a standard 250 µg cosyntropin test.
resultsFifty-eight (30.2%) of 192 patients had residual GC production, more common in men (n = 33; P < 0.002) and in shorter disease duration (median 6 [0-44] vs 13 [0-53] years; P < 0.001). Residual MC production was found in 26 (13.5%) patients and associated with shorter disease duration (median 5.5 [0.5-26.0] vs 13 [0-53] years; P < 0.004), lower fludrocortisone replacement dosage (median 0.075 [0.050-0.120] vs 0.100 [0.028-0.300] mg; P < 0.005), and higher plasma renin concentration (median 179 [22-915] vs 47.5 [0.6-658.0] mU/L; P < 0.001). There was no significant association between residual production and frequency of adrenal crises or quality of life. None had a normal cosyntropin response, but peak cortisol strongly correlated with unstimulated cortisol (r = 0.989; P < 0.001) and plasma adrenocorticotropic hormone (ACTH; r = -0.487; P < 0.001).
conclusionIn established AAD, one-third of the patients still produce GCs even decades after diagnosis. Residual production is more common in men and in patients with shorter disease duration but is not associated with adrenal crises or quality of life.
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