Changes in Adrenal Function and Insufficiency Symptoms After Cessation of Prednisolone
Authors' conclusion
This cross-sectional study of 267 patients with polymyalgia rheumatica or giant cell arteritis found a GIAI prevalence of 1.9% after cessation of prednisolone.
Study context
- Population
- Patients with PMR and/or GCA investigated a median (IQR) of 39 (25–62) days after planned cessation of prednisolone (median 13 [10–20] months of treatment), 3 Danish hospitals, March 2021 to March 2024145 female [55%]
- Participants
- 267 patients
- Exposure
- Symptomatic vs Asymptomatic
- Symptomaticn = 75
- Outcome
- GIAI: stimulated plasma cortisol <420 nmol/L in response to a short 250 μg corticotropin test (SST)
Methodological detailsmulticentre, baseline data from an ongoing randomised clinical trial
- Multicentre
- Baseline data from an ongoing randomised clinical trial
Main finding
As reported in the abstract
Prevalence of GIAI
GC-induced adrenal insufficiency (GIAI), 5 patients
1.9%
95% CI 0.8%–4.3%
Observational data: associations, not effects.
Secondary outcomes
Basal cortisol level · lower in symptomatic
P < 0.001
Symptoms compatible with adrenal insufficiency (AddiQoL-30 score 85 or lower)
- Symptomatic, 75 patients
- 34% (95% CI, 28%-41%)
Factors associated with low AddiQoL-30 score
- Female sex, percentage (PR)
- 1.68 (95% CI, 1.13-2.51)
- Increased body fat percentage, PR
- 2.33 (95% CI, 1.21-4.50)
- Reduced handgrip strength, PR
- 2.71 (95% CI, 1.44-5.10)
- Low Short Physical Performance Battery score, PR
- 2.78 (95% CI, 1.42-5.42)
Original publication
Changes in Adrenal Function and Insufficiency Symptoms After Cessation of Prednisolone. JAMA Netw Open. Published 3 March 2025. doi:10.
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