title: Adrenal insufficiency and adrenal replacement therapy. Current status in Spain.
abstract: Adrenal insufficiency (AI) is a rare endocrine disease, associated to increased mortality if left untreated. It can be due to a primary failure of the adrenal glands (primary AI) or malfunctioning of the hypothalamic-pituitary-adrenal axis (HPA) (secondary AI). The lack of data on incidence/prevalence of adrenal insufficiency in Spain complicates any evaluation of the magnitude of the problem in our country. Initial symptoms are non-specific, so often there is a delay in diagnosis. Current therapy with available glucocorticoids is associated with decreased quality of life in patients with treated AI, as well as with increased mortality and morbidity, probably related to both over-treatment and lack of hydrocortisone, associated with non-physiological peaks and troughs of the drug over the 24 hours. The availability of a new drug with a modified dual release (immediate and retarded), that requires one only daily dose, improves and simplifies the treatment, increases compliance as well as quality of life, morbidity and possibly mortality. This revision deals with the knowledge on the situation both globally and in Spain, prior to the availability of this new drug.
authors: Servicio de Endocrinología, Instituto de Investigaciones Biomédicas Sant Pau (IIB), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: Anna
authors: A
authors: Aulinas
authors: Felipe
authors: F
authors: Casanueva
authors: Fernando
authors: F
authors: Goñi
authors: Susana
authors: S
authors: Monereo
authors: Basilio
authors: B
authors: Moreno
authors: Antonio
authors: A
authors: Picó
authors: Manel
authors: M
authors: Puig-Domingo
authors: Javier
authors: J
authors: Salvador
authors: Francisco J
authors: FJ
authors: Tinahones
authors: Susan M
authors: SM
authors: Webb
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000309:Adrenal Insufficiency / Q000150:complications / Q000401:mortality / Q000628:therapy*; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic; D013030:Spain
chemical_list: D000305:Adrenal Cortex Hormones