Differential effects of hydrocortisone, prednisone, and dexamethasone on hormonal and pharmacokinetic profiles: a pilot study in children with congenital adrenal hyperplasia

• Published in: International journal of pediatric endocrinology 2016-09, Vol.2016 (1), p.17-17, Article 17
• Main Authors: Nebesio, Todd D, Renbarger, Jamie L, Nabhan, Zeina M, Ross, Sydney E, Slaven, James E, Li, Lang, Walvoord, Emily C, Eugster, Erica A
• Format: Article
• Language: English
• Subjects: Adrenogenital syndrome; Complications and side effects; Dexamethasone; Dosage and administration; Drug therapy; Genetic aspects; Hydrocortisone; Pharmacogenetics; Prednisone
• ISSN: 1687-9848; 1687-9856; 1687-9856
• DOI: 10.1186/s13633-016-0035-5

Little is known about the comparative effects of different glucocorticoids on the adrenal and growth hormone (GH) axes in children with congenital adrenal hyperplasia (CAH). We sought to compare the effects of hydrocortisone (HC), prednisone (PDN), and dexamethasone (DEX) in children with classic CAH and to investigate a potential role of pharmacogenetics. Subjects were randomly assigned to three sequential 6-week courses of HC, PDN, and DEX, each followed by evaluation of adrenal hormones, IGF-1, GH, and body mass index (BMI). Single nucleotide polymorphism (SNP) analysis of genes in the glucocorticoid pathway was also performed. Nine prepubertal subjects aged 8.1 ± 2.3 years completed the study. Mean ACTH, androstenedione, and 17-hydroxyprogesterone (17-OHP) values were lower following the DEX arm of the study than after subjects received HC (p ≤ 0.016) or PDN (p ≤ 0.002). 17-OHP was also lower after HC than PDN (p