Journal
BEST PRACTICE & RESEARCH CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 23, Issue 2, Pages 221-232Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.beem.2008.09.010
Keywords
circadian rhythm; adrenal insufficiency; congenital adrenal hyperplasia; modified release hydrocortisone
Categories
Ask authors/readers for more resources
Current therapy with immediate-release hydrocortisone is the most commonly used regimen for replacement in patients with primary and secondary adrenal insufficiency. However, conventional hydrocortisone cannot provide the physiological rhythm of cortisol release. Physicians have used fixed twice- or thrice-daily doses, but these regimens inevitably result in temporary over- or under-replacement. Patients with adrenal insufficiency, although on treatment, have a poor quality of life and an increased mortality. Optimization of current treatment has been attempted with thrice-daily, weight-related closing, but this Still fails to simulate the normal diurnal rhythm of cortisol. Recent research has investigated circadian hydrocortisone therapy imitating the physiological cortisol rhythm. Proof-of-concept studies using hydrocortisone infusions predict improvements in biochemical control and quality of life. Now delayed and sustained release oral formulations of hydrocortisone are being developed, and these offer a more practical and effective solution for patients with adrenal insufficiency and congenital adrenal hyperplasia. (C) 2008 Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available