Endocrine Abstracts

The glucocorticoid replacement therapy has been virtually unchanged since the invention of cortisone 60 years ago. Studies in patients with primary adrenal insufficiency have indicated increased mortality and unfavourable metabolic effects such as reduced bone mineral density, and evidence has accumulated that these patients suffer from reduced health-related quality of life (HRQoL). Although these endpoints possibly relate to inappropriate glucocorticoid therapy, the impact of glucocorticoid replacement regimens has been little studied. Furthermore, the source of the large interindividual variation in treatment effect is largely unknown and needs to be addressed.

We will discuss how to evaluate the patient with adrenal insufficiency and a practical approach to the treatment. Recent developments in glucocorticoid replacement therapy such as modified-release formulations and subcutaneous hydrocortisone infusion will be presented.