Cosyntropin

Does Cosyntropin work?

Yes, in large controlled trials as a test: 679 patients across 13 studies.

The use cosyntropin is known for is the ACTH stimulation test, and the evidence is diagnostic-accuracy data, with no treatment trials. A meta-analysis pooled patient-level data from 13 studies with 679 subjects and found the test discriminates adrenal insufficiency well, with the low-dose version performing better than the standard dose for chronic pituitary-related insufficiency. Decades of routine clinical use rest on this kind of validation. ¹²

Kazlauskaite and colleagues searched the studies from 1966 to 2006. They got patient-level data from 13 of 23 eligible studies. That covered 679 subjects. They compared two tests, standard-dose and low-dose cosyntropin. They checked each against reference diagnoses of hypothalamic-pituitary-adrenal insufficiency. The measure was the area under the ROC curve. It shows how well a test tells disease from health. A score of 1.0 is perfect. The low-dose test scored 0.92. The standard-dose test scored 0.79. Seven studies gave both tests to the same 254 patients. There the low-dose test did better (0.94 versus 0.85). ¹

The authors concluded that the low-dose test is more accurate for chronic secondary insufficiency. They noted practical problems. The low dose must be diluted from the standard vial. Small errors in dilution change the result. ¹

Read the full Cosyntropin page

Reference information only, not medical advice. Drawn from the Cosyntropin article, fact-checked against the cited sources. No dosing anywhere on this site.