Isidori AM, et al. - Researchers here sought to demonstrate if the timing and pharmacokinetics of glucocorticoid replacement therapy affect the metabolism and immune system of patients with adrenal insufficiency. Observations revealed a pro-inflammatory state and weakened immune defense among patients with adrenal insufficiency on conventional glucocorticoid replacement therapy multiple times a day. In patients with adrenal insufficiency, restoration of a more physiological circadian glucocorticoid rhythm by switching to a once-daily, modified-release regimen reduced bodyweight, normalized the immune cell profile, reduced recurrent infections, and improved the quality of life.