Long-term corticosteroid replacement in patients with adrenal insufficiency and measuring patient experience.

摘要

The prevalence of primary adrenal insufficiency has been estimated to be as high as 117 to 144 per million persons (1-3), whereas the prevalence of secondary adrenal insufficiency is higher at 278 per million (4). Patients with adrenal insufficiency receiving long-term corticosteroid replacement have been reported to have impaired general health, adverse effects on bone metabolism, increased cardiovascular risk, and increased mortality (5). Functional, emotional, and social limitations have also been recognized in these patients (6). Corticosteroid replacement in both primary and secondary adrenal insufficiency continues to be a challenge because of the high interindividual variability of baseline needs and metabolism of corticosteroids, as well as the need for uneven circadian supplementation (7,8).