Conventional steroids vs. dual-release hydrocortisone on metabolic, cardiovascular, and bone outcomes in adrenal insufficiency: a 10-year study.

This article focuses on a 10-year randomized study comparing the long-term effects of conventional glucocorticoids (GCs) versus dual-release hydrocortisone (DR-HC) in treatment-naive patients with primary and secondary adrenal insufficiency (AI). The study found that conventional GC therapy was associated with significant worsening in body weight, metabolic parameters (including insulin sensitivity and lipid profile), cardiovascular outcomes (such as increased interventricular septum thickness and higher frequency of acute coronary events), and bone mineral density compared to DR-HC. In contrast, DR-HC, characterized by a more physiological once-daily hydrocortisone release, showed no adverse impact on these clinical outcomes, suggesting a lower risk of developing related comorbidities. These findings highlight the potential benefits of DR-HC over conventional GCs in managing AI, although further studies with larger cohorts are recommended to confirm these results.