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L M Mongioì Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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R A Condorelli Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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S La Vignera Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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A E Calogero Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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hydrocortisone dose of 15–25 mg ( 8 ). The conventional treatment involves a double or triple administration of glucocorticoid, thus causing a supraphysiological cortisol exposition. Recently, a new once-daily dual-release hydrocortisone formulation has been

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V Guarnotta Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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C Di Stefano Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Santoro Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Ciresi Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Coppola Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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C Giordano Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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). Once-daily dual-release hydrocortisone (DR-HC) has been demonstrated to provide a cortisol exposure-time profile close to the physiological one. It is characterized by an immediate-release fraction of HC in the outer layer of the tablet and an extended-release

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Filippo Ceccato Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Elisa Selmin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Chiara Sabbadin Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Miriam Dalla Costa Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Giorgia Antonelli Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mario Plebani Laboratory Medicine, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Mattia Barbot Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Corrado Betterle Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Marco Boscaro Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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Carla Scaroni Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy

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(expressed as area under the curve, AUC) in patients with adrenal insufficiency during conventional hydrocortisone (conv-HC) and with dual-release hydrocortisone (DR-HC) compared to healthy controls. conv-HC ( n  = 18) DR-HC ( n  = 18) P conv

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Sirazum Choudhury Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Karim Meeran Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, Commonwealth Building, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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-term outcomes. Dual-release hydrocortisone (herein referred to as Plenadren), and prednisolone both offer a once-daily solution to glucocorticoid replacement therapy. Apart from the convenience and improved adherence to treatment with once-daily dosing, both

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David J F Smith Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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Karim Meeran Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK

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crises, whereas excessive replacement puts patients at the risk of Cushingoid symptoms and cardiovascular disease ( 6 , 7 ). In an attempt to mimic circadian rhythmicity, hydrocortisone analogues have been developed, including dual release hydrocortisone

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Marcus Quinkler Endocrinology in Charlottenburg, Berlin, Germany

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Bertil Ekman Departments of Endocrinology and Medical and Health Sciences, Linköping University, Linköping, Sweden

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Claudio Marelli Shire International GmbH, Zug, Switzerland

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Sharif Uddin Shire, Lexington, Massachusetts, USA

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Pierre Zelissen Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, the Netherlands

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Robert D Murray Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds, UK

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on behalf of the EU-AIR Investigators
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hydrocortisone group, we excluded patients receiving glucocorticoids other than hydrocortisone and those receiving dual-release hydrocortisone. Matched analysis Patients receiving prednisolone at doses <3 mg/day and >6 mg/day in the prednisolone group

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Salem A Beshyah Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
Diabetes and Endocrine Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates

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Khawla F Ali Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain

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Hussein F Saadi Department of Endocrinology, Medical Subspecialties Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

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modified- and dual-release hydrocortisone (Chronocort® and Plenadren®) may allow for safer fasting practices ( 19 , 20 ). Chronocort®, a modified-release formulation of hydrocortisone, administered twice daily at predawn and at sunset, has been shown to

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Kathrin R Frey Department of Medicine I, Endocrine and Diabetes Unit, University Hospital, University of Würzburg, Würzburg, Germany

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Tina Kienitz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Julia Schulz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Manfred Ventz Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Kathrin Zopf Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Marcus Quinkler Endocrinology in Charlottenburg, Berlin, Germany

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Giampietro A Mazziotti G De ML Giustina A. Bone safety of dual-release hydrocortisone in patients with hypopituitarism . Endocrine 2018 60 528 – 531 . ( https://doi.org/10.1007/s12020-017-1512-1 ) 29313195 10.1007/s12020-017-1512-1

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Angelica Sharma Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Deborah Papadopoulou Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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Karim Meeran Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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. ( https://doi.org/10.1530/EC-17-0257 ) 6 Choudhury S Tan T Lazarus K & Meeran K . The use of prednisolone versus dual-release hydrocortisone in the treatment of hypoadrenalism . Endocrine Connections 2021 10 R66 – R76 . ( https://doi.org/10

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Kamran Iqbal Shire, London, UK

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Kate Halsby pH Associates, Marlow, UK

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Robert D Murray Leeds Centre for Diabetes & Endocrinology, St James’s University Hospital, Leeds, UK

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Paul V Carroll Department of Endocrinology, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK

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Robert Petermann Shire, Vienna, Austria

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trial of a novel hydrocortisone dual-release formulation . Journal of Clinical Endocrinology and Metabolism 2012 97 473 – 481 . ( https://doi.org/10.1210/jc.2011-1926 ) 10.1210/jc.2011-1926 8 Bergthorsdottir R Nilsson AG Gillberg P Ekman B

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