PMID: 18209872Jan 23, 2008Paper

Pharmacological management of Cushing's syndrome: an update

Arquivos brasileiros de endocrinologia e metabologia
Cuong Nguyen Dang, P J Trainer

Abstract

The treatment of choice for Cushing's syndrome remains surgical. The role for medical therapy is twofold. Firstly it is used to control hypercortisolaemia prior to surgery to optimize patient's preoperative state and secondly, it is used where surgery has failed and radiotherapy has not taken effect. The main drugs used inhibit steroidogenesis and include metyrapone, ketoconazole, and mitotane. Drugs targeting the hypothalamic-pituitary axis have been investigated but their roles in clinical practice remain limited although PPAR-gamma agonist and somatostatin analogue som-230 (pasireotide) need further investigation. The only drug acting at the periphery targeting the glucocorticoid receptor remains Mifepristone (RU486). The management of Cushing syndrome may well involve combination therapy acting at different pathways of hypercortisolaemia but monitoring of therapy will remain a challenge.

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Citations

Nov 26, 2013·Endocrine·Diego FeroneRosario Pivonello
Jan 15, 2014·Endocrine·Annamaria ColaoFelipe F Casanueva
Apr 27, 2012·Clinical Endocrinology·Elena ValassiSusan M Webb
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Jul 23, 2013·Journal of Medicinal Chemistry·Juliette EmmerichRolf W Hartmann

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