Adrenal insufficiency is conventionally treated with multiple daily doses of hydrocortisone, while once-daily low-dose prednisolone has emerged as a convenient alternative for glucocorticoid replacement therapy; however, comparative evidence regarding their effects on metabolism and bone turnover remains limited. To address this gap, a study evaluated differences in metabolic parameters and bone turnover markers between patients receiving once-daily low-dose prednisolone and those treated with thrice-daily hydrocortisone for adrenal insufficiency in 46 participants.
The study found that prednisolone treatment was associated with significantly slower bone turnover compared with hydrocortisone, demonstrated by lower levels of carboxylated osteocalcin (mean treatment difference, −1.22 ng/mL), undercarboxylated osteocalcin (−1.38 ng/mL), urinary N-terminal telopeptide (−9.34 nmol/mmol), and…
