Metabolic Effects of Modified‐Release Hydrocortisone Versus Short Acting Conventional Oral Glucocorticoids in Adrenal Insufficiency: A Systematic Review and Meta‐Analysis
Authors' conclusion
MR-HC demonstrated improved effects on anthropometric measures, lipid profile, blood pressure, bone mineral density, and safety and tolerability compared to conventional GC with no apparent differences in glucose metabolism.
Study context
- Population
- Patients with adrenal insufficiency's (AI); comparative articles published until July 2025 (PubMed, Scopus, Web of Science)
- Participants
- 400 patients6 studies
- Comparison
- Modified-release hydrocortisone (MR-HC) vs conventional glucocorticoid (GC)
- Outcome
- Glucose metabolism, anthropometrics, lipid profile and blood pressure
Methodological detailsprospectively registered
- Prospectively registered
Pooled result
As reported in the abstract
Each group vs GCEstimate (95% CI)
MR-HC
MD (BMI) −1.1(−2.11 to −0.1)
MR-HC
MD (waist circumference) −5.03(−8.54 to −1.51)
MR-HC
MD (total cholesterol) −10.64(−19.86 to −1.42)
MR-HC
MD (systolic blood pressure) −6.03(−10.95 to −1.1)
MR-HC
MD (diastolic blood pressure) −4.35(−7.37 to −1.34)
Further pooled results
| Outcome | Estimate |
|---|---|
| Bone health: lumbar spine and femoral neck T-scoreMR-HC vs GC | lumbar spine T-score 0.69 (95% CI 0.16–1.22) |
| Bone health: lumbar spine and femoral neck T-scoreMR-HC vs GC | femoral neck T-score 0.64 (95% CI 0.16–1.12) |
| AddiQol scoreNot favouring MR-HC | AddiQol score 4.00 (95% CI −0.68 to 8.68) |
Safety
| Outcome | Estimate |
|---|---|
| Safety and tolerabilityMR-HC vs GC | Infection score −1.7 (95% CI −2.6 to −0.8) |
| Safety and tolerabilityMR-HC vs GC | flu-like events −1.0 (95% CI −1.6 to −0.4) |
| Safety and tolerabilityMR-HC vs GC · not favouring MR-HC | vertebral fractures 0.20 (95% CI 0.03–1.55) |
Original publication
Metabolic Effects of Modified‐Release Hydrocortisone Versus Short Acting Conventional Oral Glucocorticoids in Adrenal Insufficiency: A Systematic Review and Meta‐Analysis. Clin Endocrinol (Oxf). Published 28 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →