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The following is a summary of “Use Of Prednisolone 2.5 mg Daily During Ramadan Fasting In Patients With Adrenal Insufficiency,” published in the December 2024 issue of Endocrinology by Mok et al.
Patients with adrenal insufficiency (AI) face challenges during Ramadan fasting, requiring careful glucocorticoid (GC) therapy management. While a prior study showed that 5 mg of prednisolone daily was safe, the effects of a 2.5 mg dose have not been explored.
Researchers conducted a prospective study to assess the safety and QoL impact of prednisolone 2.5 mg daily during Ramadan fasting in patients with AI.
They recruited patients with AI who were on hydrocortisone twice daily and administered prednisolone 2.5 mg once daily at sahur (predawn) during Ramadan. Weight, sleep duration, physical activity, biochemical parameters, and QoL (SF-36 questionnaire) were measured at the end of Ramadan and compared to baseline data before Ramadan.
The results showed 16 patients, 10 men with a median age of 60 [50.3, 68] years, all on 15-20 mg of hydrocortisone, 5 participants had type 2 diabetes with a low International Diabetes Federation-Diabetes Advocacy Risk (IDF-DAR) risk category, and 18.7% were unable to complete all 29 days of fasting. Up to 62.5% experienced at least 1 AEs. Statistically significant weight reduction (median: −1.6 [−2.5, −0.3] kg, P<.01), systolic blood pressure (median: −17.0 [−28.8, −4.3] mmHg, P<.01), and diastolic blood pressure (median: −13.0 [−17.8, −3.8] mmHg, P<.01), were evaluated while QoL measures were preserved across all domains.
They concluded that prednisolone 2.5 mg daily was insufficient for patients with AI during Ramadan fasting, as this led to significant reductions in weight and blood pressure. Further studies with higher doses of prednisolone were needed.
Source: onlinelibrary.wiley.com/doi/10.1111/cen.15176
