 11β-HSD1 inhibition in men mitigates prednisolone-induced adverse effects in a proof-of-concept randomised double-blind placebo-controlled trialNantia Othonos,
Riccardo Pofi,
Anastasia Arvaniti,
Sarah White,
Ilaria Bonaventura,
Nikolaos Nikolaou,
Ahmad Moolla,
Thomas Marjot,
Roland H. Stimson,
André P. Beek,
Martijn Faassen,
Andrea M. Isidori,
Elizabeth Bateman,
Ross Sadler,
Fredrik Karpe,
Paul M. Stewart,
Craig Webster,
Joanne Duffy,
Richard Eastell,
Fatma Gossiel,
Thomas Cornfield,
Leanne Hodson,
K. Jane Escott,
Andrew Whittaker,
Ufuk Kirik,
Ruth L. Coleman,
Charles A. B. Scott,
Joanne E. Milton,
Olorunsola Agbaje,
Rury R. Holman and
Jeremy W. Tomlinson ()
Nature Communications, 2023, vol. 14, issue 1, 1-12 Abstract: Abstract Glucocorticoids prescribed to limit inflammation, have significant adverse effects. As 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) regenerates active glucocorticoid, we investigated whether 11β-HSD1 inhibition with AZD4017 could mitigate adverse glucocorticoid effects without compromising their anti-inflammatory actions. We conducted a proof-of-concept, randomized, double-blind, placebo-controlled study at Research Unit, Churchill Hospital, Oxford, UK (NCT03111810). 32 healthy male volunteers were randomized to AZD4017 or placebo, alongside prednisolone treatment. Although the primary endpoint of the study (change in glucose disposal during a two-step hyperinsulinemic, normoglycemic clamp) wasn’t met, hepatic insulin sensitivity worsened in the placebo-treated but not in the AZD4017-treated group. Protective effects of AZD4017 on markers of lipid metabolism and bone turnover were observed. Night-time blood pressure was higher in the placebo-treated but not in the AZD4017-treated group. Urinary (5aTHF+THF)/THE ratio was lower in the AZD4017-treated but remained the same in the placebo-treated group. Most anti-inflammatory actions of prednisolone persisted with AZD4017 co-treatment. Four adverse events were reported with AZD4017 and no serious adverse events. Here we show that co-administration of AZD4017 with prednisolone in men is a potential strategy to limit adverse glucocorticoid effects. Date: 2023 Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-36541-w Ordering information: This journal article can be ordered from DOI: 10.1038/s41467-023-36541-w Access Statistics for this article Nature Communications is currently edited by Nathalie Le Bot, Enda Bergin and Fiona Gillespie More articles in Nature Communications from Nature |
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