Metyrapone treatment in Cushing's syndrome: a real-life study

Endocrine
F CeccatoC Scaroni

Abstract

Medical treatment is increasingly used in patients with Cushing's syndrome (CS). Metyrapone (MET) is an inhibitor of 11β-hydroxylase: retrospective studies reported a decrease of cortisol secretion in 50% of cases. We evaluated the effectiveness of MET in an observational study, considering the normalization of urinary-free cortisol (UFC) and late-night salivary cortisol (LNSC) levels. We enrolled 31 patients with CS, treated with MET for at least 1 month (16 for primary treatment and 15 after surgical failure). A planned dose-titration regimen considering baseline UFC levels was adopted; MET dose was uptitrated until UFC normalization, surgery, or side effect occurrence. UFC and LNSC levels were routinely measured by liquid chromatography-tandem mass spectrometry. Patients were treated with a median dose of 1000 mg for 9 months. UFC and LNSC decreased quickly after the first month of treatment (-67 and -57% from baseline), with sustained UFC normalization up to 12 and 24 months (in 13 and 6 patients, respectively). UFC and LNSC normalized later (after 3-6 months) in patients with severe hypercortisolism (>5-fold baseline UFC). Regarding the last visit, 70 and 37% of patients normalized UFC and LNSC, respectively. Body weight r...Continue Reading

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Citations

Jun 6, 2019·Frontiers in Endocrinology·Mattia BarbotCarla Scaroni
Aug 20, 2020·Expert Review of Endocrinology & Metabolism·Cristina CapatinaMaria Fleseriu
Dec 24, 2018·Expert Opinion on Drug Discovery·S A UsanovN V Strushkevich
Feb 6, 2019·Endocrine·Yorihiro Iwasaki, Akihiro Hamasaki
May 18, 2019·Drugs·José Miguel Hinojosa-AmayaMaria Fleseriu
Dec 29, 2020·Frontiers in Endocrinology·Rosario PivonelloAnnamaria Colao
Mar 13, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·Elena V VarlamovMaria Fleseriu
Oct 5, 2021·Frontiers in Endocrinology·Julia Simões Corrêa GalendiVania Dos Santos Nunes Nogueira

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