GuidelineJournal of endocrinological investigation2020
Towards the tailoring of glucocorticoid replacement in adrenal insufficiency: the Italian Society of Endocrinology Expert Opinion.
Guideline in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 44 citations in OpenAlex.
- Micro- and macrovascular function in patients suffering from primary adrenal insufficiency: a cross-sectional case-control study.Journal of endocrinological investigation · 2021Trial
- Novel biomarkers to guide glucocorticoid replacement in primary adrenal insufficiency: a proof-of-concept study using copeptin-derived ratios.Journal of endocrinological investigation · 2026Article
- Clinical Course of COVID-19 in Children With Adrenal Insufficiency: Results From National Data.The Journal of clinical endocrinology and metabolism · 2025Article
- Dual-release hydrocortisone treatment improves serum and peripheral blood mononuclear cell inflammatory and immune profiles in patients with autoimmune primary adrenal insufficiency.Frontiers in immunology · 2025Article
- The Glucocorticoid Receptor: Isoforms, Functions, and Contribution to Glucocorticoid Sensitivity.Endocrine reviews · 2024Review
- Effects of Dual-Release Hydrocortisone on Bone Metabolism in Primary and Secondary Adrenal Insufficiency: A 6-Year Study.Journal of the Endocrine Society · 2023Article
- Glucocorticoids and cognitive function: a walkthrough in endogenous and exogenous alterations.Journal of endocrinological investigation · 2023Review
- Pituitary adenoma consistency affects postoperative hormone function: a retrospective study.BMC endocrine disorders · 2023Article
- Rare forms of genetic paediatric adrenal insufficiency: Excluding congenital adrenal hyperplasia.Reviews in endocrine & metabolic disorders · 2023Review
- Review
- Renin and electrolytes indicate the mineralocorticoid activity of fludrocortisone: a 6 year study in primary adrenal insufficiency.Journal of endocrinological investigation · 2023Article
- Sellar and parasellar lesions in the transition age: a retrospective Italian multi-centre study.Journal of endocrinological investigation · 2023Article
- Susceptibility and characteristics of infections in patients with glucocorticoid excess or insufficiency: the ICARO tool.European journal of endocrinology · 2022Article
- New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden.Diagnostics (Basel, Switzerland) · 2022Review
- Daily Glucocorticoid Replacement Dose in Adrenal Insufficiency, a Mini Review.Frontiers in endocrinology · 2022Review
- Rethinking the management of immune checkpoint inhibitor-related adrenal insufficiency in cancer patients during the COVID-19 pandemic.Endocrinology, diabetes & metabolism · 2021Review
- Characterization of patients with adrenal insufficiency and frequent adrenal crises.European journal of endocrinology · 2021Article
- What we have to know about corticosteroids use during Sars-Cov-2 infection.Journal of endocrinological investigation · 2021Review
- Frequently Asked Questions in Patients With Adrenal Insufficiency in the Time of COVID-19.Frontiers in endocrinology · 2021Review
- Empiric Determination of the Daily Glucocorticoid Replacement Dose in Adrenal Insufficiency.Journal of the Endocrine Society · 2020Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextGlucocorticoid (GC) replacement therapy in patients with adrenal insufficiency (AI) is life saving. After over 50 years of conventional GC treatment, novel formulations are now entering routine clinical practice.
methodsGiven the spectrum of medications currently available and new insights into the understanding of AI, the authors reviewed relevant medical literature with emphasis on original studies, prospective observational data and randomized controlled trials performed in the past 35 years. The Expert Opinion of a panel of selected endocrinologists was sought to answer specific clinical questions. The objective was to provide an evidence-supported guide, for the use of GC in various settings from university hospitals to outpatient clinics, that offers specific advice tailored to the individual patient.
resultsThe Panel reviewed available GC replacement therapies, comprising short-acting, intermediate and long-acting oral formulations, subcutaneous formulations and the novel modified-release hydrocortisone. Advantages and disadvantages of these formulations were reviewed.
conclusionsIn the Panel's opinion, achieving the optimal GC timing and dosing is needed to improve the outcome of AI. No-single formulation offers the best option for every patients. Recent data suggest that more emphasis should be given to the timing of intake. Tailoring of GS should be attempted in all patients-by experts-on a case-by-case basis. The Panel identified specific subgroups of AI patients that could be help by this process. Long-term studies are needed to confirm the short-term benefits associated with the modified-release GCs. The impact of GC tailoring has yet to be proven in terms of hospitalization rate, morbidity and mortality.
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Registered trials
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