Observational studyEuropean journal of endocrinology2023
Glucocorticoid withdrawal syndrome following surgical remission of endogenous hypercortisolism: a longitudinal observational study.
Observational study in European journal of endocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- Efficacy and safety of relacorilant for the treatment of patients with Cushing's syndrome (GRACE): a multicentre, phase 3, double-blind, placebo-controlled, randomised-withdrawal study.The lancet. Diabetes & endocrinology · 2026Trial
- Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement.The Journal of clinical endocrinology and metabolism · 2026Review
- Potential mechanisms of the glucocorticoid withdrawal syndrome.European journal of endocrinology · 2026Review
- Article
- Weaning patients off long-term prednisolone: a survey of physicians' practice in the UK and Southeast Asia.BMJ open · 2025Article
- Impact of Meditation Device Use on Quality of Life of Patients Following Surgery for Hypercortisolism.Journal of the Endocrine Society · 2025Article
- A Novel Mouse Model of the Glucocorticoid Withdrawal Syndrome.Journal of the Endocrine Society · 2025Article
- Practical guidance for stopping glucocorticoids.Australian prescriber · 2025Review
- An Analysis of Post-Adrenalectomy Dynamics in MACS (Mild Autonomous Cortisol Secretion)-Positive Adrenal Tumours: The Biomarkers and Clinical Impact.Journal of clinical medicine · 2025Review
- Osilodrostat Safety Profile: Findings from Real-World Data in the FAERS Database.Journal of clinical medicine · 2025Article
- Impact of hydrocortisone vs prednisone therapy on postsurgical recovery in patients with endogenous hypercortisolism: a prospective cohort study.European journal of endocrinology · 2025Article
- Osilodrostat Treatment for Adrenal and Ectopic Cushing Syndrome: Integration of Clinical Studies With Case Presentations.Journal of the Endocrine Society · 2025Review
- Cushing syndrome.Nature reviews. Disease primers · 2025Review
- Cosyntropin Stimulation Testing is More Selective than Postoperative Day 1 Basal Cortisol for Diagnosing Secondary Adrenal Insufficiency After Unilateral Adrenalectomy.Annals of surgical oncology · 2024Article
- Observational
- Mild autonomous cortisol secretion: pathophysiology, comorbidities and management approaches.Nature reviews. Endocrinology · 2024Review
- Iatrogenic adrenal insufficiency in adults.Nature reviews. Endocrinology · 2024Review
- Clinical characteristics of adrenal crisis in 371 adult patients with glucocorticoid-induced adrenal insufficiency.Frontiers in endocrinology · 2024Article
- Challenges in the postsurgical recovery of cushing syndrome: glucocorticoid withdrawal syndrome.Frontiers in endocrinology · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectiveGlucocorticoid withdrawal syndrome (GWS) is a scarcely studied phenomenon that complicates the recovery following surgical remission of hypercortisolism. We aimed to characterize the presence and trajectory of glucocorticoid withdrawal symptoms in the postoperative period and to determine presurgical predictors of GWS severity.
designLongitudinal observational study.
methodsGlucocorticoid withdrawal symptoms were prospectively evaluated weekly for the first 12 weeks following surgical remission of hypercortisolism. Quality of life (CushingQoL and Short-Form-36) and muscle function (hand grip strength and sit-to-stand test) were assessed at the baseline and at 12 weeks after surgery.
resultsPrevalent symptoms were myalgias and arthralgias (50%), fatigue (45%), weakness (34%), sleep disturbance (29%), and mood changes (19%). Most symptoms persisted, while myalgias, arthralgias, and weakness worsened during weeks 5-12 postoperatively. At 12 weeks after surgery, normative hand grip strength was weaker than at baseline (mean Z-score delta -0.37, P = .009), while normative sit-to-stand test performance improved (mean Z-score delta 0.50, P = .013). Short-Form-36 Physical Component Summary score worsened (mean delta -2.6, P = .015), but CushingQoL score improved (mean delta 7.8, P < .001) at 12 weeks compared to baseline. Cushing syndrome (CS) clinical severity was predictive of postoperative GWS symptomology.
conclusionGlucocorticoid withdrawal symptoms are prevalent and persistent following surgical remission of hypercortisolism with baseline CS clinical severity predictive of postoperative GWS symptom burden. Differential changes observed in muscle function and quality of life in the early postoperative period may reflect the competing influences of GWS and recovery from hypercortisolism.
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