Related Experiment Video
Updated: May 8, 2026

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
Published on: May 26, 2023
An oral multiparticulate, modified-release, hydrocortisone replacement therapy that provides physiological cortisol
Martin Whitaker1, Miguel Debono1, Hiep Huatan1
1Academic Unit of Diabetes, Endocrinology and Reproduction, University of Sheffield, Sheffield, UK (M.D., R.J.R); Diurnal Ltd, Cardiff, UK (M.W., H.H.); National Institutes of Health Clinical Center and The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA (D.M.); Centre for Endocrinology, Diabetes and Metabolism, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK (W.A.).
New hydrocortisone formulations using multiparticulate technology successfully mimic physiological cortisol profiles in adrenal insufficiency patients. This breakthrough offers improved cortisol replacement therapy by replicating natural diurnal rhythms.
Area of Science:
- Endocrinology
- Pharmacology
- Drug Delivery Systems
Background:
- Current hydrocortisone replacement therapy fails to replicate the natural diurnal cortisol profile in patients with adrenal insufficiency.
- Previous attempts using modified-release technologies have been unsuccessful in achieving physiological cortisol profiles.
Purpose of the Study:
- To develop novel hydrocortisone formulations utilizing multiparticulate technology to accurately mimic the diurnal cortisol profile.
- To overcome limitations of existing hydrocortisone replacement therapies.
Main Methods:
- In vitro dissolution testing of various formulations.
- Pharmacokinetic (PK) studies in dexamethasone-suppressed dogs and humans.
- Comparison of cortisol profiles with a reference physiological population.
- Development and testing of a specific formulation, DIURF-006.
Main Results:
- A multiparticulate formulation (DIURF-006) with delayed release (enteric coat only) demonstrated sustained hydrocortisone absorption.
- In dexamethasone-suppressed volunteers, DIURF-006 replicated physiological cortisol profiles, achieving comparable AUC, Cmax, and Tmax.
- The formulation showed 89% relative bioavailability and dose-proportional cortisol increases.
Conclusions:
- A multiparticulate oral hydrocortisone formulation with an enteric coat effectively provides delayed and sustained absorption.
- The 'toothbrush' regimen with this formulation successfully mimics physiological cortisol exposure in patients.
- This represents a significant advancement in hydrocortisone replacement therapy for adrenal insufficiency.
Related Concept Videos
Cushing Syndrome I: Introduction
Cushing Syndrome II: Pathophysiology
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
Drug Delivery: Miscellaneous Routes
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs through the...
Hypothalamic-Pituitary Axis

