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Effect of once-daily, modified-release hydrocortisone versus standard glucocorticoid therapy on metabolism and innate immunity in patients with adrenal insufficiency (DREAM): a single-blind, randomised controlled trial
Andrea M Isidori ,
Mary Anna Venneri ,
Chiara Graziadio ,
Chiara Simeoli ,
Daniela Fiore ,
Valeria Hasenmajer ,
Emilia Sbardella ,
Daniele Gianfrilli ,
Carlotta Pozza ,
Patrizio Pasqualetti ,
Stefania Morrone ,
Angela Santoni ,
Fabio Naro ,
Annamaria Colao ,
Rosario Pivonello ,
Andrea Lenzi
March 2018
March 2018
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Abstract
Conventional treatment of patients with adrenal insufficiency involves administration
of glucocorticoids multiple times a day and has been associated with weight gain and
metabolic impairment. The optimal glucocorticoid replacement therapy for these patients
is highly debated because of the scarcity of evidence from randomised trials. We aimed
to establish whether the timing and pharmacokinetics of glucocorticoid replacement
therapy affect the metabolism and immune system of patients with adrenal insufficiency.