Modified-release hydrocortisone: Is it time to change clinical practice?

Abstract

The appreciation of the unacceptable outcomes of patients with adrenal insufficiency has brought new developments in glucocorticoid replacement therapy. Efforts have moved beyond simple dose adjustments of the traditional immediate-release hydrocortisone to new formulations of hydrocortisone aimed at mimicking the circadian pattern of physiological glucocorticoid release. The present report has briefly summarized the evidence base behind recent studies that have reported benefits using modified-release preparations and set this in context for today's clinical practice.