ArticleFrontiers in endocrinology2025
Morning serum cortisol as a predictor of synacthen stimulation test outcomes during corticosteroid withdrawal: a comparative analysis of high-dose and low-dose protocols.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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
2 citing papers in PubMed.
- The 40Journal of clinical research in pediatric endocrinology · 2026Article
- Diagnostic utility of morning serum cortisol in predicting short synacthen test outcomes in outpatients with suspected adrenal insufficiency.BMC endocrine disorders · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Prolonged corticosteroid therapy may result in hypothalamic-pituitary-adrenal (HPA) axis suppression and subsequent adrenal insufficiency (AI). The short Synacthen stimulation test (SST) remains the gold standard for assessing adrenal function, yet morning serum cortisol (MSC) may serve as a valuable screening tool during corticosteroid withdrawal. Objective: To evaluate the diagnostic performance of MSC in predicting SST outcomes during glucocorticoid withdrawal and to compare the results of high-dose (HDT) versus low-dose (LDT) Synacthen stimulation protocols. Methods: This retrospective analysis examined 164 SSTs performed between 2006-2021 in patients undergoing prednisone withdrawal assessment. LDT (1 µg Synacthen) was utilized from 2006-2010, followed by HDT (250 µg Synacthen) from 2010-2021. Receiver operating characteristic (ROC) analysis was employed to determine optimal MSC thresholds for predicting adequate adrenal response, defined as cortisol ≥18 µg/dL (500 nmol/L) at 30 minutes. Results: No significant differences were observed between LDT and HDT protocols regarding stimulated cortisol levels or test outcomes. ROC analysis revealed optimal MSC thresholds of 10.4 µg/dL (287 nmol/L) for LDT and 11.2 µg/dL (309 nmol/L) for HDT. In the entire cohort, MSC threshold of 10.9 µg/dL (301 nmol/L) demonstrated balanced sensitivity (70%) and specificity (85.5%). Notably, among patients with MSC levels between 10-15 µg/dL (276-414 nmol/L), and 10-12 µg/dL (276-331 nmol/L), 40% and 48% failed the SST, respectively. Conclusions: No significant differences were observed between LDT and HDT protocols regarding stimulated cortisol levels or test outcomes, and MSC provides valuable adjunctive information for assessing HPA axis recovery. However, a substantial proportion of patients with MSC near the recommended discontinuation threshold of 10 µg/dL (300 nmol/L) still demonstrate abnormal SST responses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.