Perspectives on the management of adrenal insufficiency: Clinical insights from across Europe
European Journal of Endocrinology, ISSN: 0804-4643, Vol: 169, Issue: 6, Page: R165-75
2013
- 100Citations
- 180Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
Citation Benchmarking is provided by Scopus and SciVal and is different from the metrics context provided by PlumX Metrics.
Metrics Details
- Citations100
- Citation Indexes99
- 99
- CrossRef84
- Clinical Citations1
- PubMed Guidelines1
- Captures180
- Readers180
- 180
Review Description
Background: Conventional glucocorticoid (GC) replacement for patients with adrenal insufficiency (AI) is inadequate. Patients with AI continue to have increased mortality and morbidity and compromised quality of life despite treatment and monitoring. Objectives: i) To review current management of AI and the unmet medical need based on literature and treatment experience and ii) to offer practical advice for managing AI in specific clinical situations. Methods: The review considers the most urgent questions endocrinologists face in managing AI and presents generalised patient cases with suggested strategies for treatment. Results: Optimisation and individualisation of GC replacement remain a challenge because available therapies do not mimic physiological cortisol patterns. While increased mortality and morbidity appear related to inadequate GC replacement, there are no objective measures to guide dose selection and optimisation. Physicians must rely on experience to recognise the clinical signs, which are not unique to AI, of inadequate treatment. The increased demand for corticosteroids during periods of stress can result in a life-threatening adrenal crisis (AC) in a patient with AI. Education is paramount for patients and their caregivers to anticipate, recognise and provide proper early treatment to prevent or reduce the occurrence of ACs. Conclusions: This review highlights and offers suggestions to address the challenges endocrinologists encounter in treating patients with AI. New preparations are being developed to better mimic normal physiological cortisol levels with convenient, once-daily dosing which may improve treatment outcomes. © 2013 The authors.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84888225393&origin=inward; http://dx.doi.org/10.1530/eje-13-0450; http://www.ncbi.nlm.nih.gov/pubmed/24031090; https://academic.oup.com/ejendo/article/169/6/R165/6661719; http://www.eje-online.org/cgi/doi/10.1530/EJE-13-0450; http://www.eje-online.org/content/169/6/R165
Oxford University Press (OUP)
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