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

Full 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.

Author information

Author/s: Alkatib, Aziz A (AA); Cosma, Mihaela (M); Elamin, Mohamed B (MB); Erickson, Dana (D); Swiglo, Brian A (BA); Erwin, Patricia J (PJ); Montori, Victor M (VM);

Affiliation: Department of Medicine, Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, Minnesota 55905, USA.

Journal and publication information

Publication Type: Journal Article; Meta-Analysis; Review

Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab), published in United States. (Language: eng)

Reference: 2009-Oct; vol 94 (issue 10) : pp 3676-81

Dates: Created 2009/10/07; Completed 2009/10/20;

PMID: 19773400, status: MEDLINE (last retrieval date: 10/20/2009, IMS Date: )

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