The use of prednisolone during Ramadan fasting in patients with adrenal insufficiency
Authors' conclusion
This study has demonstrated that converting patients with AI who are fasting for Ramadan from twice-daily hydrocortisone to prednisolone 5 mg daily at sahur was safe, with no major short-term adverse effects. Despite the higher equivalent glucocorticoid doses, patients experienced weight loss and no clinically significant change in blood pressure, sleep, biochemical parameters or quality of life. This study paves the way to trial even lower doses of prednisolone once daily in patients fasting for Ramadan with AI.
Study context
- Population
- Patients with adrenal insufficiency (AI) on twice-daily hydrocortisone, low or moderate risk, intending to fast for Ramadan; mean age 59.9 ± 15.0 years, 13 men; half with T2D with low IDF-DAR risk13 men
- Participants
- 20 patients
- Exposure
- Prednisolone 5 mg once daily at sahur during Ramadan vs pre-Ramadan baseline on twice-daily hydrocortisone
- Prednisolonen = 20
- Baselinen = 20reference
- Outcome
- Change from baseline to end of Ramadan after conversion to prednisolone 5 mg once daily at sahur
- Follow-up
- End of Ramadan
Methodological detailsbefore–after comparison
- Before–after comparison
Main finding
As reported in the abstract
Weight change
−1.1 ± 1.6 kg
p = .005
Urea change
0.80 ± 1.1 mmol/L
p = .005
Haematocrit change
0.011 ± 0.019 L/L
p = .019
Serum sodium change
−1.6 ± 3.0 mmol/L
p = .028
Observational data: associations, not effects.
Further findings
Quality of life (SF-36) · end of Ramadan vs baseline
- Role limitation due to physical health, improvement
- 15.3 ± 21.6, p = .005
- Bodily pain, improvement
- 8.8 ± 16.3, p = .031
- Quality of life preserved in all domains
Completed full 29 days of fasting with no complications
- Completed full fasting with no complications
- Eighty-five percent
Safety
Completion of fasting without complications · 29 days of fasting
- Completed full 29 days of fasting with no complications
- 85%
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →