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Current and emerging therapies for Addison's disease

Napier, Catherine; Pearce, Simon H.S.

Current Opinion in Endocrinology, Diabetes and Obesity: June 2014 - Volume 21 - Issue 3 - p 147–153
doi: 10.1097/MED.0000000000000067
ADRENAL CORTEX AND MEDULLA: Edited by Anand Vaidya

Purpose of review The purpose of this article is to review the current therapy of Addison's disease and to highlight recent developments in this field.

Recent findings Conventional steroid replacement for Addison's disease consists of twice or three-times daily oral hydrocortisone and once-daily fludrocortisone; however, new treatment modalities such as modified-released hydrocortisone and continuous subcutaneous hydrocortisone infusion have recently been developed. These offer the potential for closer simulation of the physiological serum cortisol rhythm. Two studies have also looked at modifying the natural history of adrenal failure using adrenocorticotropic hormone (ACTH) stimulation and immunomodulatory therapies, leading to the concept of residual adrenal function in some Addison's disease patients.

Summary Following more than 60 years with no significant innovation in the management of Addison's disease, these new approaches hold promise for improved patient health and better quality of life in the future.

Institute of Genetic Medicine, Newcastle University, and Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK

Correspondence to Simon Pearce, Institute of Genetic Medicine, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK. Tel: +44 191 241 8674; fax: +44 191 241 8666; e-mail: simon.pearce@ncl.ac.uk

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins