Adrenal; Insufficiency Gluccorticoid-Induced Clinical Trial
Official title:
The Risk of Adrenal Insufficiency and Cushing Syndrome Associated With Glucocorticoid Therapy in People With Chronic Inflammatory Diseases
Glucocorticoids are widely used for the treatment of chronic inflammatory diseases. Although
glucocorticoids are effective in controlling disease symptoms, continuous use of the drugs
can lead to suppression of adrenal hormones or excessive cortisol level in the blood stream.
That is, excess blood cortisol level due to glucocorticoid exogenous supply can either
inhibit the 'hypothalamus-pituitary-adrenal axis' for adrenal hormones production or result
in Cushing symptoms.
In the period between 1989 and 2008 in the UK, it was estimated that 0.6%-0.8% of the general
adult population were long-term users of oral glucocorticoids. However, there is no data on
the risk of adrenal suppression and Cushing syndrome due to chronic use of glucocorticoids in
the UK to date.
The aim of the study is to investigate the risk of adrenal insufficiency and Cushing syndrome
due to long-term use of glucocorticoids in England.
Adrenal insufficiency is a clinical condition that is associated with a deficiency of adrenal
hormones, mainly: glucocorticoids and mineralocorticoids. Cushing syndrome is also a
condition that stems from the existence of persistent high cortisol level in the body. The
majority of Cushing syndrome cases are exogenous (iatrogenic or due to use of medication).
Glucocorticoids are widely used for the treatment of chronic inflammatory diseases. Although
glucocorticoids are effective in controlling disease symptoms, continuous use of the drugs
can lead to suppression of adrenal hormones or excessive cortisol level in the blood stream.
That is, excess blood cortisol level due to glucocorticoid exogenous supply can either
inhibit the 'hypothalamus-pituitary-adrenal axis' for adrenal hormones production or result
in Cushing symptoms.
In the period between 1989 and 2008 in the UK, it was estimated that 0.6%-0.8% of the general
adult population were long-term users of oral glucocorticoids. However, there is no data on
the risk of adrenal suppression and Cushing syndrome due to chronic use of glucocorticoids in
the UK to date
The aim of the study is to investigate the risk of adrenal insufficiency and Cushing syndrome
due to long-term use of glucocorticoids in England. This is a retrospective cohort study of
people diagnosed with at least one of six chronic inflammatory diseases (polymialgia
rheumatica, giant cell arteritis, systemic lupus erythematosus, rheumatoid arthritis,
vasculitis and inflammatory bowel disease).
This study will be based on the analysis of existing primary care health records routinely
collected, linked to hospital and mortality data.
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