title: Improvement of anthropometric and metabolic parameters, and quality of life following treatment with dual-release hydrocortisone in patients with Addison's disease.
abstract: In patients with Addison's disease (AD), a dual-release preparation of hydrocortisone (Plenadren, PLEN) has been demonstrated to maintain cortisol levels in a more physiological range than conventional glucocorticoid therapy, and to exert positive effects. This study aimed to assess variations of anthropometric, metabolic, and hormonal parameters in patients with AD after switching from conventional hydrocortisone (HC) treatment to PLEN. In nineteen AD patients (15 F and 4 M, age 27-65 years) treated with HC 20 mg/day thrice daily, body weight, BMI, waist circumference, fasting glucose, HbA1c, serum lipids, plasma renin activity, electrolytes, and blood pressure were evaluated at baseline, and 1, 3, 6, and 12 months after switching from HC to PLEN. At baseline, and after 1 and 12 months of PLEN, blood ACTH and cortisol (at 0800 h at fasting, and 30, 60, 90, 120, and 240 min after drug ingestion), and health-related quality of life (HRQoL), using 30-AddiQoL questionnaire, were evaluated. During PLEN, waist and serum lipid progressively decreased. After 12 months of PLEN, a significant difference was observed in waist circumference (P = 0.007), HbA1c (P = 0.002), total and LDL-cholesterol levels (P < 0.05). ACTH levels at 240 min and the area under the curve (AUC) were lower (P < 0.05) during PLEN than HC, while cortisol peaks and AUC were similar. 30-AddiQoL total score also improved (P = 0.04) during PLEN. In AD patients, PLEN reduces central adiposity, and improves glucose and metabolism parameters and HRQoL.
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, 10126, Turin, Italy. roberta.giordano@unito.it.|Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy. roberta.giordano@unito.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Giordano
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Guaraldi
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Marinazzo
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fumarola
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, 10126, Turin, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Rampino
authors.affiliation: Division of Oncological Endocrinology, Department of Medical Sciences, University of Turin, 10126, Turin, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Berardelli
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karamouzis
authors.affiliation: Clinical Biochemistry Laboratory, "Città della Salute e della Scienza di Torino" University Hospital, 10126, Turin, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Lucchiari
authors.affiliation: Clinical Biochemistry Laboratory, "Città della Salute e della Scienza di Torino" University Hospital, 10126, Turin, Italy.
authors.forename: Tilde
authors.initials: T
authors.lastname: Manetta
authors.affiliation: Clinical Biochemistry Laboratory, "Città della Salute e della Scienza di Torino" University Hospital, 10126, Turin, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Mengozzi
authors.affiliation: Division of Oncological Endocrinology, Department of Medical Sciences, University of Turin, 10126, Turin, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Arvat
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
mesh_terms: D000224:Addison Disease / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D003692:Delayed-Action Preparations; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D055105:Waist Circumference / Q000187:drug effects
chemical_list: D003692:Delayed-Action Preparations; D005938:Glucocorticoids; D008055:Lipids; D006854:Hydrocortisone
keywords: Addison’s disease; Dual-release hydrocortisone; Metabolism; QoL