ESPE Abstracts

Background: Childhood adrenal insufficiency (AI) is generally treated with immediate release hydrocortisone (IRH), which has a short half-life, requiring multiple daily doses. Modified-release hard hydrocortisone capsules (Efmody®) (MRH) is licenced for use in children >12yrs with congenital adrenal hyperplasia (CAH).

Aims: (1) Describe the characteristics of children switched to MRH; (2) Report blood spot 17-hydroxyprogesterone (17-OHP) (CAH patients) and serum cortisol (non-CAH patients) levels during MRH treatment.

Methods: Retrospective single-centre case-series of children with primary AI [CAH or Addison’s Disease (AD)] and with secondary AI (SAI) treated with MRH.

Results: Patient characteristics are shown in Table 1. Subject 8 (with SAI) stopped MRH due to a lack of symptomatic improvement after 1 month so had no cortisol profiles. Subject 9 (with SAI) had no cortisol day curves obtained before transitioning to adult services. 17-OHP and cortisol profiles are shown in Table 2. Three patients (2 with AD and 1 with SAI) required additional afternoon doses of IRH.

Discussion: These data were collected in a clinical setting, and sampling times varied between patients and treatments. However, cortisol concentrations were high in the morning and low in the afternoon during MRH treatment and 17-OHP profiles were not significantly different. This selected group of patients may not be representative of all paediatric AI patients. Further paediatric pharmacokinetic studies are required.