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.Citation
Pharmacological management of Cushing's syndrome: an update. 2007, 51 (8):1339-48 Arq Bras Endocrinol MetabolJournal
Arquivos Brasileiros de Endocrinologia e MetabologiaPubMed ID
18209872Type
ArticleLanguage
enISSN
0004-2730Collections
Related articles
- Medical treatment of Cushing's syndrome: adrenal-blocking drugs and ketaconazole.
- Authors: Feelders RA, Hofland LJ, de Herder WW
- Issue date: 2010
- Drugs in the medical treatment of Cushing's syndrome.
- Authors: Schteingart DE
- Issue date: 2009 Dec
- Medical therapy of Cushing's disease: where are we now?
- Authors: Alexandraki KI, Grossman AB
- Issue date: 2010
- Mitotane, metyrapone, and ketoconazole combination therapy as an alternative to rescue adrenalectomy for severe ACTH-dependent Cushing's syndrome.
- Authors: Kamenický P, Droumaguet C, Salenave S, Blanchard A, Jublanc C, Gautier JF, Brailly-Tabard S, Leboulleux S, Schlumberger M, Baudin E, Chanson P, Young J
- Issue date: 2011 Sep
- Advances in medical therapies for Cushing's syndrome.
- Authors: Tritos NA, Biller BM
- Issue date: 2012 Feb