Title |
Update on medical treatment for Cushing’s disease
|
---|---|
Published in |
Clinical Diabetes and Endocrinology, September 2016
|
DOI | 10.1186/s40842-016-0033-9 |
Pubmed ID | |
Authors |
Daniel Cuevas-Ramos, Dawn Shao Ting Lim, Maria Fleseriu |
Abstract |
Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome (CS). The goal of treatment is to rapidly control cortisol excess and achieve long-term remission, to reverse the clinical features and reduce long-term complications associated with increased mortality. While pituitary surgery remains first line therapy, pituitary radiotherapy and bilateral adrenalectomy have traditionally been seen as second-line therapies for persistent hypercortisolism. Medical therapy is now recognized to play a key role in the control of cortisol excess. In this review, all currently available medical therapies are summarized, and novel medical therapies in phase 3 clinical trials, such as osilodrostat and levoketoconazole are discussed, with an emphasis on indications, efficacy and safety. Emerging data suggests increased efficacy and better tolerability with these novel therapies and combination treatment strategies, and potentially increases the therapeutic options for treatment of CD. New insights into the pathophysiology of CD are highlighted, along with potential therapeutic applications. Future treatments on the horizon such as R-roscovitine, retinoic acid, epidermal growth factor receptor inhibitors and somatostatin-dopamine chimeric compounds are also described, with a focus on potential clinical utility. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 66 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 13 | 20% |
Student > Ph. D. Student | 10 | 15% |
Student > Postgraduate | 7 | 11% |
Other | 6 | 9% |
Researcher | 4 | 6% |
Other | 7 | 11% |
Unknown | 19 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 26 | 39% |
Biochemistry, Genetics and Molecular Biology | 7 | 11% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 6% |
Agricultural and Biological Sciences | 3 | 5% |
Nursing and Health Professions | 2 | 3% |
Other | 6 | 9% |
Unknown | 18 | 27% |