Modified-release hydrocortisone is associated with lower plasma renin activity in patients with salt-wasting congenital adrenal hyperplasia
Authors' conclusion
6 months of MR-HC therapy decreased PRA and increased sodium levels indicating a greater agonist action of the 9α-fluorocortisol dose, which may be due to the decreased levels of the MC-receptor antagonist 17OHP.
Study context
- Population
- Patients with salt-wasting congenital adrenal hyperplasia (CAH); Mineralocorticoid (MC) replacement therapy unchanged throughout
- Participants
- 42 vs 41
- Comparison
- Twice daily modified-release hydrocortisone (MR-HC) vs standard glucocorticoid (GC) therapy
- MR-HCn = 42
- Standard GCn = 41reference
Methodological details6-month
- 6-month
Primary result
As reported in the abstract
Plasma renin activity (PRA), change from baseline · baseline to 24 weeks
| Group | Value | P (within-group change) |
|---|---|---|
| MR-HC | median 0.83 to 0.48 (IQR 1.0–0.61) ng L-1 s-1 | P = .012 |
| Standard GC | median 0.53 to 0.52 (IQR 0.66–0.78) ng L-1 s-1 | P = .613 |
Value
MR-HCmedian 0.83 to 0.48 (IQR 1.0–0.61) ng L-1 s-1
Standard GCmedian 0.53 to 0.52 (IQR 0.66–0.78) ng L-1 s-1
P (within-group change)
MR-HCP = .012
Standard GCP = .613
Further findings
Morning serum 17OHP · 24 weeks · significantly lower with MR-HC
P = 0.001
| Outcome | MR-HC | Standard GC |
|---|---|---|
| Serum sodium, change from baseline · baseline to 24 weeks | 138.8 to 139.3 ± 1.9–1.8 mmol L-1 | 139.8 to 139.3 ± 1.6–1.9 mmol L-1 |
| P (within-group change) | P = .047 | P = .135 |
Serum sodium, change from baseline · baseline to 24 weeks
- Sodium increased on MR-HC, unchanged on standard GC
Systolic and diastolic BP and serum potassium
- No significant changes in systolic and diastolic BP and serum potassium
Original publication
Modified-release hydrocortisone is associated with lower plasma renin activity in patients with salt-wasting congenital adrenal hyperplasia. Eur J Endocrinol. Published 19 January 2023. doi:10.
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