Objective: The use of once-daily dual-release HC (DR-HC) in primary adrenal insufficiency (PAI) is often associated with benefits in metabolic parameters when compared to immediate-release HC (IR-HC). In this study, we evaluated the effects on clinical, biochemical and metabolic parameters of switching from IR-HC to lower-dose DR-HC given both in once and fractionated daily doses. Methods: Twenty autoimmune-PAI subjects were included. Patients on 30 mg/day divided in three doses IR-HC regimen (group A) were switched to DR-HC 25 mg/day given in two daily doses (20 mg in the morning and 5 mg at 2.00 p.m.); patients on 25 mg/day divided in two doses IR-HC regimen (group B) were switched to DR-HC 20 mg once daily. Biochemical and metabolic parameters, BMI and quality of life (QoL) were evaluated at the baseline and six months after the switch. Results: Our small non-randomized study with short follow up showed significant benefits in both group A and group B without any apparent side-effects. After the switch to DR-HC, a significant decrease in adrenocorticotropic hormone (ACTH), HbA1c, total cholesterol, triglycerides, LDL, cholesterol, BMI as well as a significant improvement in QoL, were observed in both groups. At 6 months, ACTH levels were lower in group A while HbA1C and total cholesterol were lower in group B. Conclusion: The DR-HC is a valid and effective therapeutic strategy to improve the metabolic control and the QoL in PAI. The reduction of ACTH levels with DR-HC regimens reflects a better biochemical control of PAI, obtained by using a lower dose and more physiological HC formulation. Both once-daily and fractionated daily doses of DR-HC showed advantages compared with IR-HC formulation.
Objective: The use of once-daily dual-release HC (DR-HC) in primary adrenal insufficiency (PAI) is often associated with benefits in metabolic parameters when compared to immediate-release HC (IR-HC). In this study, we evaluated the effects on clinical, biochemical and metabolic parameters of switching from IR-HC to lower-dose DR-HC given both in once and fractionated daily doses. Methods: Twenty autoimmune-PAI subjects were included. Patients on 30 mg/day divided in three doses IR-HC regimen (group A) were switched to DR-HC 25 mg/day given in two daily doses (20 mg in the morning and 5 mg at 2.00 p.m.); patients on 25 mg/day divided in two doses IR-HC regimen (group B) were switched to DR-HC 20 mg once daily. Biochemical and metabolic parameters, BMI and quality of life (QoL) were evaluated at the baseline and six months after the switch. Results: Our small non-randomized study with short follow up showed significant benefits in both group A and group B without any apparent side-effects. After the switch to DR-HC, a significant decrease in adrenocorticotropic hormone (ACTH), HbA1c, total cholesterol, triglycerides, LDL, cholesterol, BMI as well as a significant improvement in QoL, were observed in both groups. At 6 months, ACTH levels were lower in group A while HbA1C and total cholesterol were lower in group B. Conclusion: The DR-HC is a valid and effective therapeutic strategy to improve the metabolic control and the QoL in PAI. The reduction of ACTH levels with DR-HC regimens reflects a better biochemical control of PAI, obtained by using a lower dose and more physiological HC formulation. Both once-daily and fractionated daily doses of DR-HC showed advantages compared with IR-HC formulation.
Authors: Lalantha Leelarathna; Louise Breen; James K Powrie; Stephen M Thomas; Rustom Guzder; Barbara McGowan; Paul V Carroll Journal: Endocrine Date: 2010-07-03 Impact factor: 3.633
Authors: Gudmundur Johannsson; Alberto Falorni; Stanko Skrtic; Hans Lennernäs; Marcus Quinkler; John P Monson; Paul M Stewart Journal: Clin Endocrinol (Oxf) Date: 2014-10-10 Impact factor: 3.478
Authors: G Johannsson; A G Nilsson; R Bergthorsdottir; P Burman; P Dahlqvist; B Ekman; B E Engström; T Olsson; O Ragnarsson; M Ryberg; J Wahlberg; B M K Biller; J P Monson; P M Stewart; H Lennernäs; S Skrtic Journal: J Clin Endocrinol Metab Date: 2011-11-23 Impact factor: 5.958
Authors: S R Peacey; C Y Guo; A M Robinson; A Price; M A Giles; R Eastell; A P Weetman Journal: Clin Endocrinol (Oxf) Date: 1997-03 Impact factor: 3.478
Authors: R Giordano; S Marzotti; M Balbo; S Romagnoli; E Marinazzo; R Berardelli; G Migliaretti; A Benso; A Falorni; E Ghigo; E Arvat Journal: J Endocrinol Invest Date: 2009-07-20 Impact factor: 4.256
Authors: Martina M Erichsen; Kristian Løvås; Beate Skinningsrud; Anette B Wolff; Dag E Undlien; Johan Svartberg; Kristian J Fougner; Tore J Berg; Jens Bollerslev; Bjarne Mella; Joyce A Carlson; Henry Erlich; Eystein S Husebye Journal: J Clin Endocrinol Metab Date: 2009-10-26 Impact factor: 5.958
Authors: Martina M Erichsen; Kristian Løvås; Kristian J Fougner; Johan Svartberg; Erik R Hauge; Jens Bollerslev; Jens P Berg; Bjarne Mella; Eystein S Husebye Journal: Eur J Endocrinol Date: 2008-11-14 Impact factor: 6.664