Indian Journal of Endocrinology and Metabolism

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 22  |  Issue : 5  |  Page : 636--640

It is time to carpe diem with porcine ACTH – A comparison of porcine sequence corticotropin to tetracosactide hexaacetate in testing the hypothalamic pituitary adrenal axis in healthy individuals


Nalini B Wagmode, Vivek Mathew, Ganapathy Bantwal, Vageesh Ayyar, Belinda George, CP Patanjali, John Michael 
 Department of Endocrinology, St. John's Hospital and Medical College, Bengaluru, Karnataka, India

Correspondence Address:
Nalini B Wagmode
Department of Endocrinology, St. John's Hospital and Medical College, Bengaluru - 560 034, Karnataka
India

Context: Our literature search revealed that the use of porcine sequence corticotropin has not been validated against tetracosactide hexaacetate in a healthy population. Aims: To study the efficacy of using porcine sequence corticotropin in comparison with tetracosactide hexaacetate in the evaluation of hypothalamo pituitary adrenal (HPA) axis. Materials and Methods: Fifteen healthy volunteers were enrolled. Serum cortisol was measured at 0 minute in all subjects and at 30 and 60 minutes after tetracosactide hexaacetate 250 μg intravenously. Four weeks later, serum cortisol level was measured at 0 minute and at 30 and 60 minutes following 24 units of porcine sequence corticotropin given intramuscularly. Results: Mean serum cortisol values with tetracosactide were 30.3 (±7.83) μg/dl and 31.27 (±7.36) μg/dl at 30 and 60 minutes, respectively. The mean cortisol values with porcine sequence corticotropin were 26.33 (±5.47) μg/dl and 31.59 (±6.40) μg/dl at 30 and 60 minutes, respectively. All subjects had a response qualified as normal or adequate at 30 minutes itself. Mean peak serum cortisol response was 32.65 (±7.76) μg/dl in tetracosactide group and 31.59 (±6.4) μg/dl in porcine sequence corticotropin group, and the responses in two groups were comparable (P = 0.686). There were no immediate side effects in both groups, with a lower cost of procedure in the porcine corticotropin group. Conclusion: Our study established the efficacy of porcine sequence corticotropin in testing the adequacy of HPA axis in healthy individuals. Our study also revealed that, the intactness of the HPA axis could be confirmed as early as 30 minutes in healthy individuals.


How to cite this article:
Wagmode NB, Mathew V, Bantwal G, Ayyar V, George B, Patanjali C P, Michael J. It is time to carpe diem with porcine ACTH – A comparison of porcine sequence corticotropin to tetracosactide hexaacetate in testing the hypothalamic pituitary adrenal axis in healthy individuals.Indian J Endocr Metab 2018;22:636-640


How to cite this URL:
Wagmode NB, Mathew V, Bantwal G, Ayyar V, George B, Patanjali C P, Michael J. It is time to carpe diem with porcine ACTH – A comparison of porcine sequence corticotropin to tetracosactide hexaacetate in testing the hypothalamic pituitary adrenal axis in healthy individuals. Indian J Endocr Metab [serial online] 2018 [cited 2020 Oct 25 ];22:636-640
Available from: https://www.ijem.in/article.asp?issn=2230-8210;year=2018;volume=22;issue=5;spage=636;epage=640;aulast=Wagmode;type=0