Effects of glucocorticoid replacement therapy in patients with pituitary disease: A new perspective for personalized replacement therapy

Secondary adrenal insufficiency (SAI) is an endocrine disorder due to impaired secretion of ACTH resulting from any disease affecting the pituitary gland. Glucocorticoid replacement therapy is mandatory to ensure patient survival, haemodynamic stability, and quality of life. In fact, a correct dose...

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Bibliographic Details
Published in:	Reviews in endocrine & metabolic disorders Vol. 25; no. 5; pp. 855 - 873
Main Authors:	Chiloiro, Sabrina, Vicari, Alessandra, Mongelli, Ginevra, Costanza, Flavia, Giampietro, Antonella, Mattogno, Pier Paolo, Lauretti, Liverana, Olivi, Alessandro, De Marinis, Laura, Doglietto, Francesco, Bianchi, Antonio, Pontecorvi, Alfredo
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-10-2024 Springer Nature B.V
Subjects:	Adrenal Insufficiency - drug therapy Adrenocorticotropic hormone Body fat Circadian rhythm Cognition & reasoning Diabetes Electrolytes Endocrine disorders Endocrinology Epidemiology Glucocorticoids Glucocorticoids - adverse effects Glucocorticoids - therapeutic use Glucose Hormone replacement therapy Hormone Replacement Therapy - methods Humans Internal Medicine Medicine Medicine & Public Health Metabolic disorders Metastasis Mortality Patients Physiology Pituitary Pituitary Diseases - drug therapy Pituitary gland Precision Medicine - methods Quality of life Tumors Craniopharyngiomas Hypopituitarism Diabetes insipidus Germinoma Pituitary adenoma Metastasis Pit-NET Histiocytosis Pituitary neuroendocrine tumors Hypophysitis
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Summary:	Secondary adrenal insufficiency (SAI) is an endocrine disorder due to impaired secretion of ACTH resulting from any disease affecting the pituitary gland. Glucocorticoid replacement therapy is mandatory to ensure patient survival, haemodynamic stability, and quality of life. In fact, a correct dose adjustement is mandatory due to the fact that inappropriately low doses expose patients to hypoadrenal crisis, while inappropriately high doses contribute to glucose metabolic and cardiovascular deterioration. This review analyses the current evidence from available publications on the epidemiology and aetiology of SAI and examines the association between glucocorticoid replacement therapy and glucometabolic and cardiovascular effects.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	1389-9155 1573-2606 1573-2606
DOI:	10.1007/s11154-024-09898-6