Is DHEA replacement beneficial in chronic adrenal failure?

Lang, Katharina; Burger-Stritt, Stephanie; Hahner, Stefanie

doi:10.1016/j.beem.2014.09.007

Cited by 12 publications

(16 citation statements)

References 60 publications

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“…DHEA replacement therapy of patients with adrenal insufficiency slightly improves health-related QOL and confers positive effects on mood, sexuality and subjective health status. 20,21 In the present study we found greater improvement in the QOL of RA patients who received DHEA rather than placebo. DHEA has…”

Section: Re Sultssupporting

confidence: 53%

“…DHEA replacement therapy of patients with adrenal insufficiency slightly improves health‐related QOL and confers positive effects on mood, sexuality and subjective health status 20,21 …”

Section: Discussionmentioning

confidence: 99%

“…19 Additionally, women with adrenal insufficiency may experience improvements in health-related QOL following treatment with DHEA. 20,21 Taking into account relative adrenocortical insufficiency of RA, this study was primarily directed to investigate the effects of DHEA supplement on QOL in premenopausal women with RA.…”

Section: Introductionmentioning

confidence: 99%

“…Although DHEA has been introduced as a potential effective treatment in a number of autoimmune diseases including systemic lupus erythematosus (SLE) 12‐14 and Sjögren's syndrome (SS), 15‐18 published data regarding RA are limited 19 . Additionally, women with adrenal insufficiency may experience improvements in health‐related QOL following treatment with DHEA 20,21 . Taking into account relative adrenocortical insufficiency of RA, this study was primarily directed to investigate the effects of DHEA supplement on QOL in premenopausal women with RA.…”

Section: Introductionmentioning

confidence: 99%

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Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial

et al. 2020

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Aim: Chronic inflammation and subsequent use of glucocorticoids can lead to relative adrenocortical insufficiency in patients with rheumatoid arthritis (RA). Previously, adrenocortical hormone, dehydroepiandrosterone (DHEA) was shown as a potential therapy for autoimmune disorders. However, data regarding effects of DHEA in RA are limited. The aim of this study was to investigate the effects of DHEA on quality of life (QOL) in premenopausal rheumatoid arthritis patients. Method: In this randomized double blinded, controlled trial 46 premenopausal rheumatoid arthritis patients were assigned to receive 50 mg/d DHEA (23 patients) or placebo (23 patients) for 12 weeks. Disease Activity Score of 28 joints-erythrocyte sedimentation rate (DAS28-ESR) questionnaire, visual analog score and swollen and tender joint counts (both 0-28) were used for assessment of disease activity. Persianvalidated World Health Organization Quality of Life Brief version (WHOQOL BREF) questionnaire was used to assess quality of life. Results: In comparison to the control group more improvement in QOL (P = .025) and environment health (P = .001) was observed in the DHEA group. After adjustment for age and disease duration DHEA was associated with more improvement in QOL (P = .01), psychological (P = .02) and physical health (P = .03). A trend toward a decrease in ESR was observed in DHEA group (P = .06). DAS was improved in both groups; however, there was no significant change in DAS28 between groups (P = .88). Frequency of adverse events albeit minor was similar in both groups. Conclusion: Our study supports a slightly superior effect of DHEA over placebo to improve QOL in premenopausal female patients with rheumatoid arthritis. We did not find improvement in DAS in the DHEA group over placebo.

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Section: Re Sultssupporting

confidence: 53%

“…DHEA replacement therapy of patients with adrenal insufficiency slightly improves health‐related QOL and confers positive effects on mood, sexuality and subjective health status 20,21 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial

et al. 2020

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“…In addition to the replacement with gluco-and mineralocorticoids which are vital, androgen substitution with dehydroepiandrosterone (DHEA) is frequently discussed in women with PAI. Based on current data, DHEA replacement may be considered in women receiving optimal gluco-and mineralocorticoid therapy that are still suffering from symptoms like low libido and depressive symptoms [27,54,55], particularly if post-menopausal or having concomitant primary ovarian insufficiency with loss of ovarian androgens.…”

Section: Treatment and Prevention Of Primary Adrenal Insufficiencymentioning

confidence: 99%

An Update on Addison’s Disease

Barthel

Benker

Berens

et al. 2018

Exp Clin Endocrinol Diabetes

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Addison’s disease – the traditional term for primary adrenal insufficiency (PAI) – is defined as the clinical manifestation of chronic glucocorticoid- and/or mineralocorticoid deficiency due to failure of the adrenal cortex which may result in an adrenal crisis with potentially life-threatening consequences. Even though efficient and safe pharmaceutical preparations for the substitution of endogenous gluco- and mineralocorticoids are established in therapy, the mortality in patients with PAI is still increased and the health-related quality of life (HRQoL) is often reduced.PAI is a rare disease but recent data report an increasing prevalence. In addition to the common “classical” causes of PAI like autoimmune, infectious, neoplastic and genetic disorders, other iatrogenic conditions – mostly pharmacological side effects (e. g., adrenal haemorrhage associated with anticoagulants, drugs affecting glucocorticoid synthesis, action or metabolism and some of the novel anti-cancer checkpoint inhibitors) are contributing factors to this phenomenon.Due to the rarity of the disease and often non-specific symptoms at least in the early stages, PAI is frequently not considered resulting in a delayed diagnosis. Successful therapy is mainly based on adequate patient education as a cornerstone in the prevention and management of adrenal crisis. A focus of current research is in the development of pharmacokinetically optimized glucocorticoid preparations as well as regenerative therapies.

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Morbus Addison

2016

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Adrenal insufficiency, a rare disorder which is characterized by the inadequate production or absence of adrenal hormones, may be classified as primary adrenal insufficiency in case of direct affection of the adrenal glands or secondary adrenal insufficiency, which is mostly due to pituitary or hypothalamic disease. Primary adrenal insufficiency affects 11 of 100,000 individuals. Clinical symptoms are mainly nonspecific and include fatigue, weight loss, and hypotension. The diagnostic test of choice is dynamic testing with synthetic ACTH. Patients suffering from chronic adrenal insufficiency require lifelong hormone supplementation. Education in dose adaption during physical and mental stress or emergency situations is essential to prevent life-threatening adrenal crises. Patients with adrenal insufficiency should carry an emergency card and emergency kit with them.

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Is DHEA replacement beneficial in chronic adrenal failure?

Cited by 12 publications

References 60 publications

Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial

Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial

An Update on Addison’s Disease

Morbus Addison

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