Optimal glucocorticoid replacement in adrenal insufficiency

摘要: Adrenal insufficiency (glucocorticoid deficiency) comprises a group of rare diseases, including primary adrenal insufficiency, secondary and congenital hyperplasia. Lifesaving glucocorticoid therapy was introduced over 60 years ago, but since then number advances in treatment have taken place. Specifically, little is known about short- long-term effects, morbidity mortality. Over the past decade, systematic cohort registry studies described reduced health-related quality life, an unfavourable metabolic profile increased mortality patients with which may relate to unphysiological replacement. This has led development new modes replacement that aim mimic normal physiology. Here, evidence for inadequacy conventional recent developments are reviewed, emphasis on insufficiency.