Impact of glucocorticoid treatment duration and dosage on the risk of secondary adrenal insufficiency

Ally Prebtani, MD, is a professor of medicine at the Faculty of Health Sciences of McMaster University.

Which is the stronger risk factor for the development of glucocorticoid-induced adrenal insufficiency: treatment duration or dosage?

Ally Prebtani, MD: Again, it’s the same thing. There’s no one factor that’s important for determining the risk of glucocorticoid adrenal insufficiency. It is again, all the things I mentioned earlier: dose, duration, the type of glucocorticoid, bedtime versus morning administration, other patient factors, such as other therapies, other medications that they may be on, are they getting frequent courses for prolonged time? Are they children who are at higher risk? Genetic variability… all these factors affect the risk. It’s not just the dose or the duration, it’s multiple things that we need to take into account.