Home > Journals > Minerva Endocrinologica > Past Issues > Articles online first > Minerva Endocrinologica 2017 Jul 27

CURRENT ISSUE
 

ARTICLE TOOLS

Publication history
Reprints
Cite this article as

MINERVA ENDOCRINOLOGICA

A Journal on Endocrine System Diseases


Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,383


eTOC

 

Minerva Endocrinologica 2017 Jul 27

DOI: 10.23736/S0391-1977.17.02701-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Secondary adrenal insufficiency: from the physiopathology to the possible role of modified-release hydrocortisone treatment

Rosa M. PARAGLIOLA, Salvatore M. CORSELLO

Endocrinology, Università Cattolica del Sacro Cuore, Rome, Italy


PDF  


Central adrenal insufficiency represents a life-threatening disorder that results from a reduced cortisol production due to an impairment production of adrenocorticotropic hormone. In particular, secondary AI results from pituitary disease that impedes the release of ACTH, while tertiary adrenal insufficiency is caused from an impaired synthesis of corticotropin-releasing hormone. Central adrenal insufficiency has an estimated prevalence of 150-280 per million, resulting more common than primary AI. Prompt diagnosis and management of this condition is crucial, but the diagnostic investigation can often be challenging, in particular in cases of recent onset of secondary adrenal insufficiency. Moreover, different formulation of steroid replacement therapy are available for both primary and central adrenal insufficiency, but the therapy of choice for the treatment of secondary hypoadrenalism is still debated. In particular, several data confirm the advantages of dual-release hydrocortisone formulation in primary hypoadrenalism, while data for secondary adrenal insufficiency are still lacking. However, in spite of few clinical data, the use of dual release hydrocortisone can be extremely favorable ACTH deficiency, which is associated with an increase of overall and cardiovascular mortality, also due to the risk of overtreatment. In this condition, the use of a modified-release glucocorticoid formulation, which has been demonstrated to improve metabolic profile, can be extremely attractive.

top of page

Publication History

Article first published online: July 27, 2017
Manuscript accepted: July 7, 2017
Manuscript received: June 29, 2017

Cite this article as

Paragliola RM, Corsello SM. Secondary adrenal insufficiency: from the physiopathology to the possible role of modified-release hydrocortisone treatment. Minerva Endocrinol 2017 Jul 27. DOI: 10.23736/S0391-1977.17.02701-8

Corresponding author e-mail

corsello.sm@meridiaroma.it