{"id":"https://openalex.org/W4282944912","doi":"https://doi.org/10.55563/clinexprheumatol/x78tko","title":"Impaired adrenal cortex reserve in patients with rheumatic and musculoskeletal diseases who relapse upon tapering of low glucocorticoid dose","display_name":"Impaired adrenal cortex reserve in patients with rheumatic and musculoskeletal diseases who relapse upon tapering of low glucocorticoid dose","publication_year":2021,"publication_date":"2021-10-12","ids":{"openalex":"https://openalex.org/W4282944912","doi":"https://doi.org/10.55563/clinexprheumatol/x78tko","pmid":"https://pubmed.ncbi.nlm.nih.gov/35699085"},"language":"en","primary_location":{"id":"doi:10.55563/clinexprheumatol/x78tko","doi":"https://doi.org/10.55563/clinexprheumatol/x78tko","is_oa":false,"landing_page_url":"https://doi.org/10.55563/clinexprheumatol/x78tko","pdf_url":null,"source":{"id":"https://openalex.org/S165438840","display_name":"Clinical and Experimental Rheumatology","issn_l":"0392-856X","issn":["0392-856X","1593-098X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310321666","host_organization_name":"Springer Vienna","host_organization_lineage":["https://openalex.org/P4310321666","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Vienna","Springer Nature"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical and Experimental Rheumatology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5081592896","display_name":"Maria P. Yavropoulou","orcid":"https://orcid.org/0000-0002-6501-3692","observed_orcids":["https://orcid.org/0000-0002-6501-3692"]},"institutions":[{"id":"https://openalex.org/I200777214","display_name":"National and Kapodistrian University of Athens","ror":"https://ror.org/04gnjpq42","country_code":"GR","type":"education","lineage":["https://openalex.org/I200777214"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Maria P. Yavropoulou","raw_affiliation_strings":["Endocrinology Unit, First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Endocrinology Unit, First Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece","institution_ids":["https://openalex.org/I200777214"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5013270301","display_name":"Maria G. Filippa","orcid":"https://orcid.org/0000-0001-7438-3612","observed_orcids":["https://orcid.org/0000-0001-7438-3612"]},"institutions":[{"id":"https://openalex.org/I200777214","display_name":"National and Kapodistrian University of Athens","ror":"https://ror.org/04gnjpq42","country_code":"GR","type":"education","lineage":["https://openalex.org/I200777214"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Maria G. Filippa","raw_affiliation_strings":["First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece","institution_ids":["https://openalex.org/I200777214"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048007142","display_name":"Stylianos Panopoulos","orcid":"https://orcid.org/0000-0002-3720-5996","observed_orcids":["https://orcid.org/0000-0002-3720-5996"]},"institutions":[{"id":"https://openalex.org/I200777214","display_name":"National and Kapodistrian University of Athens","ror":"https://ror.org/04gnjpq42","country_code":"GR","type":"education","lineage":["https://openalex.org/I200777214"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Stylianos Panopoulos","raw_affiliation_strings":["First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece","institution_ids":["https://openalex.org/I200777214"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5008503354","display_name":"Evangelos Spanos","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Evangelos Spanos","raw_affiliation_strings":["Bioiatriki Health Care Group, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Bioiatriki Health Care Group, Athens, Greece","institution_ids":[]}]},{"author_position":"middle","author":{"id":null,"display_name":"George Spanos","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"George Spanos","raw_affiliation_strings":["Bioiatriki Health Care Group, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Bioiatriki Health Care Group, Athens, Greece","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5075515457","display_name":"Maria G. Tektonidou","orcid":"https://orcid.org/0000-0003-2238-0975","observed_orcids":["https://orcid.org/0000-0003-2238-0975"]},"institutions":[{"id":"https://openalex.org/I200777214","display_name":"National and Kapodistrian University of Athens","ror":"https://ror.org/04gnjpq42","country_code":"GR","type":"education","lineage":["https://openalex.org/I200777214"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Maria G. Tektonidou","raw_affiliation_strings":["First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece","institution_ids":["https://openalex.org/I200777214"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5007341235","display_name":"Petros Paul Sfikakis","orcid":"https://orcid.org/0000-0001-5484-2930","observed_orcids":["https://orcid.org/0000-0001-5484-2930"]},"institutions":[{"id":"https://openalex.org/I200777214","display_name":"National and Kapodistrian University of Athens","ror":"https://ror.org/04gnjpq42","country_code":"GR","type":"education","lineage":["https://openalex.org/I200777214"]}],"countries":["GR"],"is_corresponding":false,"raw_author_name":"Petros P. Sfikakis","raw_affiliation_strings":["First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece. psfikakis@med.uoa.gr"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece. psfikakis@med.uoa.gr","institution_ids":["https://openalex.org/I200777214"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.856,"has_fulltext":false,"cited_by_count":6,"citation_normalized_percentile":{"value":0.69460575,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"40","issue":"9","first_page":"1789","last_page":"1792"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12421","display_name":"Adrenal Hormones and Disorders","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12421","display_name":"Adrenal Hormones and Disorders","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10529","display_name":"Stress Responses and Cortisol","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2802","display_name":"Behavioral Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/adrenal-insufficiency","display_name":"adrenal insufficiency","score":0.8619999885559082},{"id":"https://openalex.org/keywords/glucocorticoid-tapering","display_name":"glucocorticoid tapering","score":0.7799999713897705},{"id":"https://openalex.org/keywords/rheumatic-and-musculoskeletal-diseases","display_name":"rheumatic and musculoskeletal diseases","score":0.9129999876022339},{"id":"https://openalex.org/keywords/acth-stimulation-test","display_name":"ACTH stimulation test","score":0.8989999890327454},{"id":"https://openalex.org/keywords/tetracosactide","display_name":"tetracosactide","score":0.890999972820282},{"id":"https://openalex.org/keywords/low-dose-prednisolone","display_name":"low-dose prednisolone","score":0.8169999718666077},{"id":"https://openalex.org/keywords/recurrence","display_name":"recurrence","score":0.6880000233650208},{"id":"https://openalex.org/keywords/iatrogenic-adrenal-insufficiency","display_name":"iatrogenic adrenal insufficiency","score":0.8420000076293945},{"id":"https://openalex.org/keywords/disease-modifying-antirheumatic-drugs","display_name":"disease-modifying antirheumatic drugs","score":0.8600000143051147},{"id":"https://openalex.org/keywords/rheumatoid-arthritis","display_name":"rheumatoid arthritis","score":0.8450000286102295},{"id":"https://openalex.org/keywords/systemic-lupus-erythematosus","display_name":"systemic lupus erythematosus","score":0.9769999980926514},{"id":"https://openalex.org/keywords/dermatomyositis","display_name":"dermatomyositis","score":0.7850000262260437}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9627504348754883},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.731967031955719},{"id":"https://openalex.org/C2779384505","wikidata":"https://www.wikidata.org/wiki/Q17007513","display_name":"Concomitant","level":2,"score":0.6234679818153381},{"id":"https://openalex.org/C2780841215","wikidata":"https://www.wikidata.org/wiki/Q422549","display_name":"Glucocorticoid","level":2,"score":0.6137763261795044},{"id":"https://openalex.org/C2777575956","wikidata":"https://www.wikidata.org/wiki/Q187255","display_name":"Rheumatoid arthritis","level":2,"score":0.5988983511924744},{"id":"https://openalex.org/C2779123688","wikidata":"https://www.wikidata.org/wiki/Q421094","display_name":"Hydroxychloroquine","level":5,"score":0.5954757928848267},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.5374804735183716},{"id":"https://openalex.org/C2776715498","wikidata":"https://www.wikidata.org/wiki/Q11426176","display_name":"Prednisolone","level":2,"score":0.5346649289131165},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.3823294937610626},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.14355838298797607},{"id":"https://openalex.org/C524204448","wikidata":"https://www.wikidata.org/wiki/Q788926","display_name":"Infectious disease (medical specialty)","level":3,"score":0.0},{"id":"https://openalex.org/C3008058167","wikidata":"https://www.wikidata.org/wiki/Q84263196","display_name":"Coronavirus disease 2019 (COVID-19)","level":4,"score":0.0}],"mesh":[{"descriptor_ui":"D000077339","descriptor_name":"Leflunomide","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D000079424","descriptor_name":"Tumor Necrosis Factor Inhibitors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000302","descriptor_name":"Adrenal Cortex","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000305","descriptor_name":"Adrenal Cortex Hormones","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D000309","descriptor_name":"Adrenal Insufficiency","qualifier_ui":"Q000139","qualifier_name":"chemically induced","is_major_topic":true},{"descriptor_ui":"D000309","descriptor_name":"Adrenal Insufficiency","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D000309","descriptor_name":"Adrenal Insufficiency","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D001172","descriptor_name":"Arthritis, Rheumatoid","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D001379","descriptor_name":"Azathioprine","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D002908","descriptor_name":"Chronic Disease","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003366","descriptor_name":"Cosyntropin","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D005938","descriptor_name":"Glucocorticoids","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006854","descriptor_name":"Hydrocortisone","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D006886","descriptor_name":"Hydroxychloroquine","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D008727","descriptor_name":"Methotrexate","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D011239","descriptor_name":"Prednisolone","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D012008","descriptor_name":"Recurrence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018501","descriptor_name":"Antirheumatic Agents","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.55563/clinexprheumatol/x78tko","doi":"https://doi.org/10.55563/clinexprheumatol/x78tko","is_oa":false,"landing_page_url":"https://doi.org/10.55563/clinexprheumatol/x78tko","pdf_url":null,"source":{"id":"https://openalex.org/S165438840","display_name":"Clinical and Experimental Rheumatology","issn_l":"0392-856X","issn":["0392-856X","1593-098X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310321666","host_organization_name":"Springer Vienna","host_organization_lineage":["https://openalex.org/P4310321666","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Vienna","Springer Nature"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical and Experimental Rheumatology","raw_type":"journal-article"},{"id":"pmid:35699085","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/35699085","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical and experimental rheumatology","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9922999739646912}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2752288901","https://openalex.org/W7167686522","https://openalex.org/W2754144203","https://openalex.org/W3022060454","https://openalex.org/W2803608838","https://openalex.org/W3115931142","https://openalex.org/W2320681331","https://openalex.org/W2017350540","https://openalex.org/W3005263233","https://openalex.org/W2149722240"],"abstract_inverted_index":{"OBJECTIVES:":[0],"To":[1],"examine":[2],"adrenal":[3,173,228],"cortex":[4],"reserve":[5],"in":[6,43,133,183,211,244],"patients":[7,46,134,189,246],"with":[8,25,89,209],"rheumatic":[9],"and":[10,125,142,159],"musculoskeletal":[11],"diseases":[12],"(RMD)":[13],"who":[14,215],"relapse":[15,69,216],"upon":[16,70,217],"tapering":[17,222],"of":[18,35,68,76,162,172,203],"low":[19,77,219],"glucocorticoid":[20,165,179,220,242],"dose,":[21],"despite":[22],"concomitant":[23,87,218],"treatment":[24,88,243],"disease-modifying":[26],"anti-rheumatic":[27],"drugs":[28],"(DMARDs).":[29],"METHODS:":[30],"A":[31],"morning":[32],"standard":[33],"dose":[34,79,221],"250":[36],"mcg":[37],"tetracosactide":[38,130,158],"(Synacthen":[39],"test)":[40],"was":[41,181],"given":[42],"25":[44],"consecutive":[45],"(13":[47],"rheumatoid":[48],"arthritis,":[49,52],"2":[50,57,62],"psoriatic":[51],"5":[53],"systemic":[54,60],"lupus":[55],"erythematosus,":[56],"dermatomyositis,":[58],"1":[59],"sclerosis,":[61],"temporal":[63],"arteritis)":[64],"at":[65],"the":[66,154],"time":[67],"small":[71],"reductions":[72],"(1-2":[73],"mg":[74,81],"daily)":[75],"prednisolone":[78],"(<7.5":[80],"daily),":[82],"while":[83],"being":[84],"on":[85],"stable":[86],"methotrexate,":[90],"leflunomide,":[91],"hydroxychloroquine,":[92],"azathioprine,":[93],"mycophenolate,":[94],"tofacitinib,":[95],"belimumab,":[96],"anti-TNF,":[97],"anti-IL-6":[98],"or":[99,164],"anti-IL-1":[100],"regimens":[101],"(n=14;":[102],"3;":[103],"9;":[104],"1;":[105,107,108],"2;":[106,110],"5;":[109],"1,":[111],"respectively).":[112,147],"Sex-matched":[113],"apparently":[114],"healthy":[115],"individuals":[116],"(n=45)":[117],"served":[118],"as":[119],"controls.":[120],"RESULTS:":[121],"Baseline":[122],"cortisol":[123,127,155,198],"levels":[124],"time-integrated":[126],"response":[128,156,199],"to":[129,157,177,240],"were":[131,151],"lower":[132,197],"than":[135,200],"controls":[136],"(12.01\u00b14.47":[137],"vs.":[138,144],"15.63\u00b14.16":[139],"mcg/dl,":[140],"p=0.001,":[141],"1050\u00b1286":[143],"1284\u00b1182,":[145],"p<0.001,":[146],"No":[148],"significant":[149],"associations":[150],"observed":[152],"between":[153],"age,":[160],"duration":[161],"disease":[163],"treatment.":[166],"An":[167],"abnormal":[168],"Synacthen":[169,193,234],"test,":[170],"indicative":[171],"insufficiency,":[174],"presumably":[175],"secondary":[176],"chronic":[178],"administration,":[180],"noted":[182],"5/25":[184],"patients.":[185],"The":[186],"remaining":[187],"20":[188],"(80%)":[190],"had":[191],"normal":[192,233],"test":[194,235],"demonstrating,":[195],"however,":[196],"controls,":[201],"independently":[202],"age":[204],"(\u03b2-coefficient=-0.373,":[205],"p=0.033).":[206],"CONCLUSIONS:":[207],"Patients":[208],"RMD":[210],"remission":[212],"under":[213],"DMARDs":[214],"should":[223,236],"be":[224],"tested":[225],"for":[226],"iatrogenic":[227],"insufficiency.":[229],"Whether":[230],"a":[231],"marginally":[232],"discourage":[237],"further":[238,248],"attempts":[239],"withdraw":[241],"these":[245],"warrants":[247],"investigation.":[249]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":4},{"year":2022,"cited_by_count":1}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2022-06-16T00:00:00"}