Evidence map›Paper›PMID 32779106›Full record

ArticleJournal of endocrinological investigation2021

What factors have impact on glucocorticoid replacement in adrenal insufficiency: a real-life study.

S Puglisi, A Rossini, I Tabaro, S Cannavò, F Ferrau', M Ragonese, G Borretta, M Pellegrino, F Dughera, A Parisi and 4 more

Open access · hybridAbstract read
In one paragraph

Article in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 2 countries.

S Puglisi *Internal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy. sorayapuglisi@yahoo.it.ORCID http://orcid.org/0000-0002-2883-6139
A Rossini *Endocrinology and Diabetes Unit, ASST Papa Giovanni XXIII, Bergamo, Italy.
I TabaroInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
S CannavòDepartment of Human Pathology 'G.Barresi', University of Messina, Messina, Italy.
F Ferrau'Department of Human Pathology 'G.Barresi', University of Messina, Messina, Italy.
M RagoneseDepartment of Human Pathology 'G.Barresi', University of Messina, Messina, Italy.
G BorrettaDivision of Endocrinology, AO S. Croce E Carle, Cuneo, Italy.
M PellegrinoDivision of Endocrinology, AO S. Croce E Carle, Cuneo, Italy.
F DugheraInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
A ParisiInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
A LatinaDivision of Endocrinology, AO S. Croce E Carle, Cuneo, Italy.
A PiaInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
M TerzoloInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
G ReimondoInternal Medicine, Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy.
University of Turin · ITAzienda Sanitaria Ospedaliera S.Croce e Carle Cuneo · ITUniversity of Messina · ITOspedale Papa Giovanni XXIII · ITYahoo (Spain) · ES

Funding

Fondi per la Ricerca Locale Università di Torino 2018 RILO 2018
6 · The paper itself

Abstract

purposeThe impact of patient's characteristics on glucocorticoid (GC) replacement therapy in adrenal insufficiency (AI) is poorly evaluated. Aims of this study were to assess the influence of sex and body weight on GC dosing and to describe the choice of GC in AI of different etiologies.

methodsWe retrospectively evaluated hydrocortisone (HC) equivalent total daily dose (HC-TDD) and per-kg-daily dose (HC-KDD) in 203 patients (104 primary AI [pAI], 99 secondary AI [sAI]) followed up for ≥ 12 months. They were treated with HC, modified-release HC (MRHC) or cortisone acetate (CA) and fludrocortisone acetate (FCA) in pAI.

resultsAt baseline, CA was preferred both in pAI and sAI; at last visit, MRHC was most used in pAI (49%) and CA in sAI (73.7%). Comparing the last visit with baseline, in pAI, HC-TDD and HC-KDD were significantly lower (p = 0.04 and p = 0.006, respectively), while FCA doses increased during follow-up (p = 0.02). The reduction of HC-TDD and HC-KDD was particularly relevant for pAI women (p = 0.04 and p = 0.002, respectively). In sAI patients, no change of HC-KDD and HC-TDD was observed, and we found a correlation between weight and HC-TDD in males (r 0.35, p = 0.02).

conclusionsOur real-life study demonstrated the influence of etiology of AI on the type of GC used, a weight-based tailoring in sAI, a likely overdosage of GC treatment in pAI women at the start of treatment and the possibility to successfully increase FCA avoiding GC over-treatment. These observations could inform the usual clinical practice.

Indexed as

Adrenal InsufficiencyBody WeightCortisoneDose-Response Relationship, DrugDrug Dosage CalculationsFemaleFludrocortisoneFollow-Up StudiesGlucocorticoidsHormone Replacement TherapyHumansItalyMaleMiddle AgedPatient Care ManagementRetrospective StudiesCortisoneFludrocortisonefludrocortisone acetateGlucocorticoidsAddisonFludrocortisoneHydrocortisoneHypoadrenalismManagement

Identifiers

PMID32779106
PMCPMC7946659
OpenAlexW3048383336

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.