Adrenal News

Adults who are prescribed glucocorticoid therapy for common conditions, such as asthma, allergies and arthritis, as well as individuals with adrenal insufficiency, are at high risk for developing serious complications from COVID-19 due to an inability to mount a normal stress response, according to an editorial published in the Journal of Clinical Endocrinology & Metabolism.

As the COVID-19 pandemic continues to worsen, endocrinologists are confronting changes large and small to the way they practice medicine. For some, that means preparing to abandon the typical clinic day and assist as needed as internists. For others, it means navigating an unprecedented, nationwide shift to telemedicine and virtual communication, all while prioritizing the patients who still urgently need an in-person consultation and the risks that come with it.

People with adrenal insufficiency or uncontrolled Cushing’s syndrome are at greater risk for death from a respiratory-related infection, such as COVID-19, and should observe several key recommendations to avoid complications, according to a new position statement issued by the American Association of Clinical Endocrinologists.

The FDA has approved the nonsteroidal corticosteroid biosynthesis inhibitor osilodrostat for adults with Cushing’s disease who cannot undergo pituitary gland surgery or have undergone the surgery but still have the disease, according to an agency press release.

A biochemical evaluation to determine the success of unilateral adrenalectomy among adults with an aldosterone-producing adenoma should occur no sooner than 3 months after surgery, due in part to early postsurgical changes in active renin concentration, according to findings published in Clinical Endocrinology.

Baseline plasma aldosterone concentration is independently associated with clinical and biochemical outcomes of treatment among adults with primary aldosteronism, and data suggest that mineralocorticoid receptor antagonist therapy is the optimal strategy vs. adrenalectomy for those with a normal plasma aldosterone concentration, according to findings published in the Journal of the Endocrine Society.

The Endocrine Society recommends medical management with a moderate level of evidence; in particular, steroidogenesis inhibitors as a second-line treatment after surgery for people with Cushing’s disease, either with or without radiotherapy, and as primary treatment for ectopic adrenocorticotropic hormone (ACTH) secretion. The guideline also recommends pituitary-directed medical treatments for patients who are not surgical candidates or who have persistent disease after surgery. The choice of medical therapy should be guided by efficacy, individual patient factors and cost.

More than a century has passed since neurosurgeon and pathologist Harvey Cushing described the disease that would eventually bear his name, but only recently have several key discoveries offered patients with the condition real hope for a cure.

In rare cases of a concurrence of primary aldosteronism and subclinical Cushing’s syndrome, the two conditions did not exhibit any additive or synergic impact on glucose or potassium metabolism or maximum tumor diameter, according to findings published in BMC Endocrine Disorders.

Endocrine Today has compiled a list of the top recent news reports focused on neuroendocrinology and adrenal medicine.