Frey K, et al. - Experts examined if patients on hydrocortisone (HC) or prednisolone demonstrated changes in bone mineral density (BMD) after follow-up of 5.5 years. They also sought to determine if BMD was altered after switching from immediate- to modified-release HC. A substantially lower BMD was found due to the use of prednisolone as hormone replacement therapy compared to HC. Findings reported that subjects on low dose HC replacement therapy exhibited unchanged Z-scores within the normal reference range during the study period.

Methods

• The scheme of this research was a prospective, observational, longitudinal study.
• An analysis was conducted of BMD by DXA at visit1, after 2.2±0.4 (visit2) and after 5.5±0.8 years (visit3) included 36 PAI and 8 CAH patients.
• A total of 13 patients received prednisolone (age 52.5±14.8yrs; 8 women), 31 patients immediate-release HC (age 48.9±15.8yrs; 22 women).
• Furthermore, 12 patients on immediate-release switched to modified-release HC at visit2.

Results

• Substantially lower Z-scores were obtained via prednisolone compared to HC at femoral neck (-0.85±0.80 vs -0.25±1.16, p < 0.05), trochanter (-0.96±0.62 vs 0.51±1.07, p < 0.05) and total hip (-0.78±0.55 vs 0.36±1.04, p < 0.05), but not at lumbar spine, throughout the study.
• As per the results, prednisolone dose decreased by 8% over study time.
• However, there was no significant effect on BMD.
• It was displayed that BMD did not notably change after switching from immediate- to modified-release HC.