Evidence map›Paper›PMID 36950738›Full record

ReviewThe Journal of clinical endocrinology and metabolism2023

Interpretation of Steroid Biomarkers in 21-Hydroxylase Deficiency and Their Use in Disease Management.

Kyriakie Sarafoglou, Deborah P Merke, Nicole Reisch, Hedi Claahsen-van der Grinten, Henrik Falhammar, Richard J Auchus

Abstract readReview
In one paragraph

Review in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

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  18. EndoBridge 2023: highlights and pearls.Hormones (Athens, Greece) · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kyriakie SarafoglouDepartment of Pediatrics, Division of Pediatric Endocrinology, University of Minnesota Medical School, Minneapolis, MN 55454, USA.ORCID 0000-0002-5741-3629
Deborah P MerkeDepartment of Pediatrics, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA.ORCID 0000-0002-3746-0460
Nicole ReischMedizinische Klinik and Poliklinik IV, Klinikum der Universität München, 80336 Munich, Germany.ORCID 0000-0002-7469-6069
Hedi Claahsen-van der GrintenDepartment of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands.ORCID 0000-0003-0181-0403
Henrik FalhammarDepartment of Molecular Medicine and Surgery, Karolinska Institutet, SE-17176, Stockholm, Sweden.ORCID 0000-0002-5622-6987
Richard J AuchusDepartments of Pharmacology and Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical School, Ann Arbor, MI 48109, USA.ORCID 0000-0001-6815-6181

Funding

Natural History Study of Patients with Excess AndrogenZIACL090091 · CLC · CLINICAL CENTER · PI MERKE, DEBORAH · 2022 to 2025
$0k
6 · The paper itself

Abstract

The most common form of congenital adrenal hyperplasia is 21-hydroxylase deficiency (21OHD), which in the classic (severe) form occurs in roughly 1:16 000 newborns worldwide. Lifelong treatment consists of replacing cortisol and aldosterone deficiencies, and supraphysiological dosing schedules are typically employed to simultaneously attenuate production of adrenal-derived androgens. Glucocorticoid titration in 21OHD is challenging as it must balance the consequences of androgen excess vs those from chronic high glucocorticoid exposure, which are further complicated by interindividual variability in cortisol kinetics and glucocorticoid sensitivity. Clinical assessment and biochemical parameters are both used to guide therapy, but the specific purpose and goals of each biomarker vary with age and clinical context. Here we review the approach to medication titration for children and adults with classic 21OHD, with an emphasis on how to interpret adrenal biomarker values in guiding this process. In parallel, we illustrate how an understanding of the pathophysiologic and pharmacologic principles can be used to avoid and to correct complications of this disease and consequences of its management using existing treatment options.

Indexed as

Adrenal Hyperplasia, CongenitalAdultBiomarkersChildDisease ManagementGlucocorticoidsHumansHydrocortisoneInfant, NewbornSteroid 21-HydroxylaseSteroidsBiomarkersGlucocorticoidsHydrocortisoneSteroid 21-HydroxylaseSteroids11-oxygenated androgens17-hydroxyprogesteronecongenital adrenal hyperplasia

Identifiers

PMID36950738
PMCPMC10438890

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.