Peptide
Cosyntropin (Cortrosyn/Synacthen)
Cosyntropin is a synthetic ACTH(1-24) peptide. FDA-approved for diagnosis of adrenocortical insufficiency. The 250mcg ACTH stimulation test is the gold standard diagnostic test. Meta-analysis shows 97% sensitivity at 95% specificity for primary adrenal insufficiency. Less immunogenic than full ACTH due to absence of amino acids 25-39. Half-life 15 minutes with peak cortisol at 30-60 minutes.
- Updated
- How we grade
- 22 studies cited
Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.
- Best evidence
- Grade A
- Conditions studied
- 1
- Outcomes
- 7
- Graded outcomes
- 4111
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
General
Key findings
- Cortisol StimulationChanges; see studies
- Safety ProfileImproves (the measure goes up)
- Diagnostic Sensitivity (Primary AI)Improves (the measure goes up)
Studies cited
22 studies from PubMed
- Examining aldosterone plasma concentration alterations post-ACTH stimulation in healthy subjects: a systematic literature review and meta-analysis on ACTH's role in aldosterone secretion.
- Salivary corticosterone measurement in large-billed crows by enzyme-linked immunosorbent assay.
- Cortisol levels in blood and hair of unanesthetized grizzly bears (Ursus arctos) following intravenous cosyntropin injection.
- Cosyntropin for the Treatment of Refractory Postdural Puncture Headache in Pediatric Patients: A Retrospective Review.
- Pitfalls in the interpretation of the cosyntropin stimulation test for the diagnosis of adrenal insufficiency
- Total and free cortisol levels during 1 μg, 25 μg, and 250 μg cosyntropin stimulation tests compared to insulin tolerance test: results of a randomized, prospective, pilot study.
- ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis
- Normal hypothalamic-pituitary-adrenal axis by high-dose cosyntropin testing in patients with abnormal response to low-dose cosyntropin stimulation: a retrospective review.
- Is the cosyntropin test redundant in the acutely ill patient suspected of adrenal insufficiency? A case report and literature review.
- Hypothalamic-pituitary-adrenal axis assessment in healthy term neonatal foals utilizing a paired low dose/high dose ACTH stimulation test.
- Autoimmune polyglandular syndrome, type II.
- Can 1 microg of cosyntropin be used to evaluate adrenal insufficiency in critically ill patients?
- Adrenal function in critically ill patients: how to test? When to treat?
- High-dose and low-dose cosyntropin stimulation tests for diagnosis of adrenal insufficiency.
- Serum concentrations of cortisol, sex hormones of adrenal origin, and adrenocortical steroid intermediates in healthy dogs following stimulation with two doses of cosyntropin.
- Diagnosis of adrenal insufficiency.
- Prevalence of abnormal adrenocortical function in human immunodeficiency virus infection by low-dose cosyntropin test.
- Severe hyperkalemia in two patients with diabetes after cosyntropin administration.
- Enhanced adrenal sensitivity to exogenous cosyntropin (ACTH alpha 1-24) stimulation in major depression. Relationship to dexamethasone suppression test results.
- Cosyntropin stimulation in adrenal vein testing for aldosteronoma.
- The use of a cosyntropin stimulation test to predict adrenal suppression in renal transplant patients being withdrawn from prednisone.
- Combined dexamethasone suppression and cosyntropin (synthetic ACTH) stimulation test in the dog: new approach to testing of adrenal gland function.