Emerging treatments
Alternative glucocorticoid formulations
Modified-release formulations of glucocorticoids and variable-rate continuous hydrocortisone infusions are designed to simulate the diurnal rhythm of physiologic cortisol secretion.[55][56][57] Experience with these treatments is limited, and it has yet to be established that in comparison with conventional treatment they offer advantages of ease of use, efficiency, or safety.
Regenerative therapies
Regenerative treatment aims to regain adrenal function by early treatment with adrenocorticotropic hormone (ACTH) on top of the supra-physiologic endogenous concentrations or to reverse the autoimmune process.[58] One study showed no improvement in adrenal function using the combination of rituximab and depot cosyntropin (a synthetic ACTH formulation) in patients with primary adrenal insufficiency.[59] These therapies, while promising in the long term, are experimental and should be undertaken only in an approved research program.
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