Table 9.

Systemic effects of dual release glucocorticoid replacement therapy in patients with SAI

Authors (Reference)	Study design	Number of patients	Dose and types of glucocorticoid  replacement therapy	Systemic effect
Quinkler et al. [168]	Clinical trial	9	Dual-release HC therapy (median dose 20 mg/d), after 6 months of treatment with conventional HC or eq	↓ BMI and HbA1c in dual reseal HC
Isidori et al. [169]	Clinical trial	46	Dual-release HC therapy for 24 weeks, after 48 months of treatment with conventional HC or eq	↓ bodyweight and better immune cells profiles in patients switched to modified-release oral hydrocortisone
Frara et al. [32]	Observational Retrospective	14	Mean 20 mg daily dual-release hydrocortisone	↓ FBG and → HbA1c, LDL, HDL, TG at 24 months of treatment ↑ BMD T-score at lumbar spine, femoral neck and total hip during 24 months of treatment
Guarnotta et al. [170]	Retrospective observational	36	Mean 20 mg/d dual-release hydrocortisone for 36 months of treatment	↓ BMI, waist circumference and HbA1c ↑HDL-C levels in patients with normal glucose tolerance and pre-diabetes ↓ Insulinemia, visceral adiposity index (VAI), insulin resistance, ↑ insulin sensitivity in prediabetic patients
Dineen et al. [171]	Clinical trial	30	Dual-release hydrocortisone for 3 months of treatment	↓ systolic and diastolic blood pressure, body weight and BMI

↑ increase, ↓ reduction, → stable, DM Diabetes Mellitus, HC hydrocortisone, CA cortisone acetate, PD prednisone, HCeq hydrocortisone-equivalents, FBG fasting blood glucose, HbA1c glycated haemoglobin, HDL high-density lipoprotein, HDL-C HDL-cholesterol, LDL low-density lipoprotein, TG triglycerides, AIx75 augmentation index, RHI reactive hyperaemia index, BMI Body Mass Index, VAI visceral adiposity index