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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2025 The Author(s). Published by Oxford University Press on behalf of the Endocrine Society.Adrenal suppression is an iatrogenic form of adrenal insufficiency that occurs secondary to exogenous glucocorticoids (GCs) and is a documented cause of premature mortality among individuals with Duchenne muscular dystrophy (DMD). Adrenal suppression in DMD necessitates awareness and careful management, given that GCs are currently the mainstay of therapy for individuals living with DMD. Vamorolone, a novel GC that has recently been approved in some regions worldwide for the treatment of DMD, has also been reported to place individuals at high risk of adrenal suppression in a dose-dependent fashion, requiring health care professional awareness. Vamorolone is a mineralocorticoid receptor antagonist, which differentiates it from classic GCs, and this characteristic impacts the approach to adrenal suppression management. This contemporary perspective provides insights into the mechanisms underlying adrenal suppression due to both classic GCs and novel vamorolone therapy, followed by an overview of adrenal suppression management with a particular focus on the unique aspects of providing care for individuals treated with vamorolone. It also emphasizes the importance of educating the DMD community and health care providers about the recognition and management of adrenal suppression and outlines critical concepts for clinicians managing adrenal suppression risk, tapering GCs, and transitioning from classic GC therapy to vamorolone. The key principles of managing adrenal suppression due to classic GCs and novel vamorolone therapy highlighted in this perspective are expected to enhance clinical practice, mitigate mortality, and optimize health outcomes for individuals with DMD.
Author(s): Sbrocchi AM, Kinnett K, Lautatzis M-E, Mcmillan HJ, Selby KA, Veerapandiyan A, Weber DR, Apkon S, Bharucha-Goebel DX, Bharill S, Bansal S, Clemens PR, Fiscaletti M, Halloun R, Lam C, Merchant N, Mcadam L, Nasomyont N, Nicolau S, Ochoa Molina MF, Phung K, Rutter MM, Scavina M, Surampudi PN, Tamaroff J, Tian C, Ward LM, Wood CL, Wong SC, Ahmet A, Furlong P, McMillan HJ, Manesh RP, Wang M, Ahmet A, Veerapandiyan A, Schrader R, Lam CKL, Babalola F, Crane JL, Sorbara JC, Benjamin R, Molina MFO, Renthal NE, Appel AM, Vargas G, Bratland LE, Truba N, Hoskin J, Werth C, Moeschen P, Zeitler P, Lewis C
Publication type: Article
Publication status: Published
Journal: Journal of the Endocrine Society
Year: 2026
Volume: 10
Issue: 2
Print publication date: 01/02/2026
Online publication date: 27/11/2025
Acceptance date: 07/11/2025
Date deposited: 26/01/2026
ISSN (electronic): 2472-1972
Publisher: Endocrine Society
URL: https://doi.org/10.1210/jendso/bvaf181
DOI: 10.1210/jendso/bvaf181
Data Access Statement: Data sharing is not applicable to this article as no datasets were generated or analyzed during the course of this work
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