A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency.

Abstract

CONTEXT:

Women with primary or secondary adrenal insufficiency report a decreased health-related quality of life (HRQOL) despite traditional adrenal replacement therapy. Dehydroepiandrosterone (DHEA) has been studied as an agent to improve HRQOL in these patients.

OBJECTIVE:

We sought to conduct a systematic review and meta-analysis of randomized controlled trials of DHEA effects on HRQOL in women with adrenal insufficiency.

DATA SOURCES:

We searched electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, CINAHL, and PsycInfo) and reference lists of eligible studies through July 2008.

STUDY SELECTION:

Eligible trials randomly assigned women with primary or secondary adrenal insufficiency to either DHEA or control and measured the effect of treatment on HRQOL.

DATA EXTRACTION:

Reviewers working independently and in duplicate assessed the methodological quality of trials and collected data on patient characteristics, interventions, and outcomes.

DATA SYNTHESIS:

We found 10 eligible trials that measured HRQOL and depression, anxiety, and sexual function. Random-effects meta-analysis showed a small improvement in HRQOL in women treated with DHEA compared with placebo [effect size of 0.21; 95% confidence interval, 0.08 to 0.33; inconsistency (I(2)) = 32%]. There was a small beneficial effect of DHEA on depression; effects on anxiety and sexual well-being were also small and not statistically significant.

CONCLUSIONS:

DHEA may improve, in a small and perhaps trivial manner, HRQOL and depression in women with adrenal insufficiency. There was no significant effect of DHEA on anxiety and sexual well-being. The evidence appears insufficient to support the routine use of DHEA in women with adrenal insufficiency.

• Authors: Aziz A Alkatib, Mihaela Cosma, Mohamed B Elamin, Dana Erickson, Brian A Swiglo, Patricia J Erwin, Victor M Montori
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 94 Issue 10 Pg. 3676-81 (Oct 2009) ISSN: 1945-7197 [Electronic] United States
• PMID: 19773400 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Dehydroepiandrosterone

Topics

• Adrenal Insufficiency (drug therapy)
• Anxiety (prevention & control)
• Dehydroepiandrosterone (pharmacology, therapeutic use)
• Depression (prevention & control)
• Health Status
• Humans
• Quality of Life
• Randomized Controlled Trials as Topic
• Research Design
• Sexual Behavior (drug effects)
• Treatment Outcome