Comparison of effects of hydrocortisone and prednisolone re-placement therapy on quality of life, metabolic and bone health parameters in primary adrenal insufficiency -an open-label parallel arm randomized controlled trial

: Hydrocortisone and prednisolone are the preferred agents for treating primary adrenal insufficiency (PAI). Hydrocortisone is still the preferred agent used to treat PAI. However, endocrinologists lack consensus regarding the impact of different steroid regimens on quality of life, cardiometabolic outcome, and bone health. Despite this preference, some studies have suggested that prednisolone may be as effective as hydrocortisone in managing primary adrenal insufficiency with fewer adverse hypertension, weight gain, and decreased BMD. There is a lack of randomized controlled trials comparing the two medications in terms of their effects on cardiometabolic risk factors, body composition parameters, bone turnover markers, and quality of life.