Mifepristone in the treatment of the ectopic adrenocorticotropic hormone syndrome

Clinical Endocrinology
Taweesak WannachaleeRichard J Auchus

Abstract

Mifepristone, a glucocorticoid receptor antagonist, can be used to manage hypercortisolism in patients with ectopic adrenocorticotropic hormone syndrome (EAS) when surgical cure is not feasible. Outcomes of EAS patients treated with mifepristone have been limited to reports of isolated cases. We aimed to determine the efficacy and limitations of mifepristone in the treatment of EAS and to compare outcomes with those of patients who underwent bilateral adrenalectomy. A retrospective cohort study of EAS patients from the University of Michigan between 1997 and 2017 was conducted. Of the 55 patients with EAS, 16 were treated with mifepristone: eight neuroendocrine tumours, two carcinomas and six occult tumours. Treatment with mifepristone was most commonly prompted by psychosis, uncontrolled glucose and/or hypertension. The median maintenance dose was 600 mg/d. Amelioration of psychosis was observed within 48 hours in 3/3 patients, and the glycaemic control was improved in 14/16 patients. The median duration of treatment was 9 months, and three patients were treated for more than 24 months. The overall survival at 24 months was equivalent between patients with EAS treated with mifepristone vs bilateral adrenalectomy (N = 12) (P = ...Continue Reading

References

Jul 25, 1987·Lancet·B BeaufrèreR François
Sep 1, 1985·The Journal of Clinical Endocrinology and Metabolism·L K NiemanD L Loriaux
Sep 27, 2001·World Journal of Surgery·J P AniszewskiJ A van Heerden
May 26, 2005·The Journal of Clinical Endocrinology and Metabolism·Ioannis IliasLynnette K Nieman
Nov 24, 2005·The Journal of Clinical Endocrinology and Metabolism·Andrea M IsidoriG Michael Besser
May 16, 2006·Lancet·John Newell-PriceLynnette K Nieman
Nov 7, 2007·European Journal of Endocrinology·Sarah Johanssen, Bruno Allolio
Mar 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Lynnette K NiemanVictor M Montori
Apr 9, 2008·European Journal of Endocrinology·Philippe A CassierCatherine Lombard-Bohas
Mar 18, 2009·European Journal of Endocrinology·F CastinettiB Conte-Devolx
Jan 5, 2011·The Journal of Clinical Endocrinology and Metabolism·R N ClaytonP W Jones
Jul 15, 2011·The Journal of Clinical Endocrinology and Metabolism·Peter KamenickýJacques Young
Apr 3, 2012·The Journal of Clinical Endocrinology and Metabolism·Maria FleseriuUNKNOWN SEISMIC Study Investigators
May 1, 2012·Current Opinion in Endocrinology, Diabetes, and Obesity·Frederic CastinettiBernard Conte-Devolx
Jan 23, 2013·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Maria FleseriuBeverly M K Biller
Feb 26, 2013·Pharmacotherapy·Farah H Morgan, Marc J Laufgraben
Mar 28, 2013·The Journal of Clinical Endocrinology and Metabolism·Olaf M DekkersHenrik Toft Sørensen
Aug 21, 2013·The Journal of Clinical Endocrinology and Metabolism·Katrin RitzelMartin Reincke
Jan 28, 2015·European Journal of Endocrinology·Jean-Benoît CorcuffAntoine Tabarin
May 23, 2015·European Journal of Endocrinology·Martin ReinckeFelix Beuschlein
May 26, 2015·Lancet·André LacroixLynnette K Nieman
Jun 30, 2015·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Kevin C J YuenDat Nguyen
Jul 30, 2015·The Journal of Clinical Endocrinology and Metabolism·Lynnette K NiemanUNKNOWN Endocrine Society
Jan 8, 2016·Endocrine-related Cancer·Carole GuerinFrederic Castinetti
May 15, 2016·The Lancet. Diabetes & Endocrinology·Rosario PivonelloAnnamaria Colao
Feb 12, 2017·European Journal of Endocrinology·Maria Vittoria Davi'Giuseppe Francia

❮ Previous
Next ❯

Citations

Jan 31, 2019·American Journal of Physiology. Renal Physiology·Richard A Zager, Ali C M Johnson
Feb 26, 2020·Case Reports in Neurological Medicine·Maria das Dores Medina-Lopes, Luiz Augusto Casulari
Nov 28, 2019·The New England Journal of Medicine·R Louise RushworthHenrik Falhammar
Nov 28, 2019·The New England Journal of Medicine·Francisco J Fernández-Fernández, Eugenia Ameneiros-Lago

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Endocrine Reviews
B L WajchenbergM A Kirschner
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Jihad R SalamehGeorge M Varkarakis
Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Harshal R KakadeNalini S Shah
© 2022 Meta ULC. All rights reserved