An update on iatrogenic adrenal insufficiency in DMD

A North American consortium of clinicians has examined one of the rare but potentially extremely serious complications of long-term corticosteroid use in Duchenne muscular dystrophy (DMD):

• the clinicians’ aim was to update the 2018 guidelines on corticosteroid-induced adrenal insufficiency in DMD,
• whilst taking into account new issues such as corticosteroid therapy in patients with Becker muscular dystrophy (BMD) or in symptomatic women who are carriers of DMD or BMD,
• and the market launch of vamorolone, a dissociative corticosteroid, as well as innovative therapies (antisense oligonucleotides, gene therapy, etc.),
• the document provides insights into the mechanisms involved in this type of iatrogenic adrenal insufficiency and simple ways to detect and prevent it.

This complication is not as rare as one might think, particularly in the North American context where long-term, high-dose corticosteroid therapy is widespread, and it deserves to be better understood.