Pharmacotherapy of Endocrine & Metabolic Disorders in the Elderly
Aylin ARICIa , Abdullah Serkan YENERb
aDokuz Eylül University Faculty of Medicine, Department of Clinical Pharmacology, İzmir, Türkiye
bDokuz Eylül University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, İzmir, Türkiye
ABSTRACT
Depending on advancing age, changes are observed in the functions of endocrine organs as well as in all organs. The frequency of endocrine diseases such as diabetes mellitus, hypothyroidism, osteoporosis, and adrenal insufficiency increases with advancing age. Since clinical drug trials are frequently conducted in patient volunteers aged 18-65 years, there is insufficient evidence regarding the use of drugs in the treatment of all these endocrine diseases in the geriatric population. It is of great importance to treat endocrine diseases in the geriatric population by taking into account the age characteristics of the patients, considering the comorbidities existing in the patients in the selection of drugs, and considering drug-drug interactions. In this review, the pharmacotherapy of these endocrine and metabolic diseases, which are common in geriatric patients, is discussed.
Keywords: Drug therapy; geriatrics; endocrine system diseases
Referanslar
- Jones CM, Boelaert K. The Endocrinology of Ageing: A Mini-Review. Gerontology. 2015;61(4):291-300. [Crossref] [PubMed]
- Owens D, Kalra S, Sahay R. Geriatric endocrinology. Indian J Endocrinol Metab. 2011;15(2):71-2. [Crossref] [PubMed] [PMC]
- Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF DIABETES ATLAS [Internet]. 10th ed. Brussels: International Diabetes Federation; 2021.
- Cai H, McNeilly AS, Luttrell LM, Martin B. Endocrine function in aging. Int J Endocrinol. 2012;2012:872478. [Crossref] [PubMed] [PMC]
- Oliveira REM, Franco LJ. Glycemic control in elderly people with type 2 diabetes mellitus attending primary health care units. Prim Care Diabetes. 2021;15(4):733-6. [Crossref] [PubMed]
- Gandhi GY, Mooradian AD. Clinical Considerations for Insulin Therapy in Older Adults with Type 1 Diabetes. Drugs Aging. 2022;39(1):23-37. [Crossref] [PubMed]
- Zeyfang A, Wernecke J, Bahrmann A. Diabetes Mellitus at an Elderly Age. Exp Clin Endocrinol Diabetes. 2023;131(1-02):24-32. [Crossref] [PubMed]
- LeRoith D, Biessels GJ, Braithwaite SS, Casanueva FF, Draznin B, Halter JB, et al. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019;104(5):1520-74. [Crossref] [PubMed] [PMC]
- Abdelhafiz AH, Sinclair AJ. Cardio-renal protection in older people with diabetes with frailty and medical comorbidities - A focus on the new hypoglycaemic therapy. J Diabetes Complications. 2020;34(9):107639. [Crossref] [PubMed]
- Yin R, Xu Y, Wang X, Yang L, Zhao D. Role of Dipeptidyl Peptidase 4 Inhibitors in Antidiabetic Treatment. Molecules. 2022;27(10):3055. [Crossref] [PubMed] [PMC]
- Lunati ME, Cimino V, Gandolfi A, Trevisan M, Montefusco L, Pastore I, et al. SGLT2-inhibitors are effective and safe in the elderly: The SOLD study. Pharmacol Res. 2022;183:106396. [Crossref] [PubMed]
- Dhaliwal R, Weinstock RS. Management of Type 1 Diabetes in Older Adults. Diabetes Spectr. 2014;27(1):9-20. [Crossref] [PubMed] [PMC]
- Ikegami H, Hiromine Y, Noso S. Insulin-dependent diabetes mellitus in older adults: Current status and future prospects. Geriatr Gerontol Int. 2022;22(8):549-53. [Crossref] [PubMed] [PMC]
- Duntas LH, Yen PM. Diagnosis and treatment of hypothyroidism in the elderly. Endocrine. 2019;66(1):63-9. [Crossref] [PubMed]
- Thiruvengadam S, Luthra P. Thyroid disorders in elderly: A comprehensive review. Dis Mon. 2021;67(11):101223. [Crossref] [PubMed]
- Effraimidis G, Watt T, Feldt-Rasmussen U. Levothyroxine Therapy in Elderly Patients With Hypothyroidism. Front Endocrinol (Lausanne). 2021;12:641560. [Crossref] [PubMed] [PMC]
- Calissendorff J, Falhammar H. To Treat or Not to Treat Subclinical Hypothyroidism, What Is the Evidence? Medicina (Kaunas). 2020;56(1):40. [Crossref] [PubMed] [PMC]
- Chen Y, Tai HY. Levothyroxine in the treatment of overt or subclinical hypothyroidism: a systematic review and meta-analysis. Endocr J. 2020;67(7):719-32. [Crossref] [PubMed]
- Antonelli A, Wartofsky L, Miccoli P. Editorial: Levothyroxine Therapy in Patients With Hypothyroidism. Front Endocrinol (Lausanne). 2021;12:734895. [Crossref] [PubMed] [PMC]
- McCahon D, Haque MS, Parle J, Hobbs FR, Roberts LM. Subclinical thyroid dysfunction symptoms in older adults: cross-sectional study in UK primary care. Br J Gen Pract. 2020;70(692):e208-e14. [Crossref] [PubMed] [PMC]
- Samuels MH, Hyperthyroidism in Aging. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. South Dartmouth (MA): 2021.
- Kahaly GJ, Bartalena L, Hegedüs L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism. Eur Thyroid J. 2018;7(4):167-86. [Crossref] [PubMed] [PMC]
- Reid IR, Billington EO. Drug therapy for osteoporosis in older adults. Lancet. 2022;399(10329):1080-92. Erratum in: Lancet. 2022;400(10354):732. [Crossref] [PubMed]
- Johnston CB, Dagar M. Osteoporosis in Older Adults. Med Clin North Am. 2020;104(5):873-84. [Crossref] [PubMed]
- Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021;28(9):973-97. [Crossref] [PubMed]
- Yong EL, Logan S. Menopausal osteoporosis: screening, prevention and treatment. Singapore Med J. 2021;62(4):159-66. [Crossref] [PubMed] [PMC]
- Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Calcif Tissue Int. 2019;104(3):235-8. [Crossref] [PubMed] [PMC]
- Rushworth RL, Torpy DJ, Falhammar H. Adrenal crises in older patients. Lancet Diabetes Endocrinol. 2020;8(7):628-39. [Crossref] [PubMed]
- Guignat L. Therapeutic patient education in adrenal insufficiency. Ann Endocrinol (Paris). 2018;79(3):167-73. [Crossref] [PubMed]
- Rushworth RL, Torpy DJ, Falhammar H. Adrenal Crisis. N Engl J Med. 2019;381(9):852-61. [Crossref] [PubMed]