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dc.contributor.authorDang, Cuong N
dc.contributor.authorTrainer, Peter J
dc.date.accessioned2009-07-07T14:51:59Z
dc.date.available2009-07-07T14:51:59Z
dc.date.issued2007-11
dc.identifier.citationPharmacological management of Cushing's syndrome: an update. 2007, 51 (8):1339-48 Arq Bras Endocrinol Metabolen
dc.identifier.issn0004-2730
dc.identifier.pmid18209872
dc.identifier.urihttp://hdl.handle.net/10541/72782
dc.description.abstractThe 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.
dc.language.isoenen
dc.subject.meshCushing Syndrome
dc.subject.meshDopamine Antagonists
dc.subject.meshHormone Antagonists
dc.subject.meshHumans
dc.subject.meshHypothalamo-Hypophyseal System
dc.subject.meshKetoconazole
dc.subject.meshMetyrapone
dc.subject.meshMifepristone
dc.subject.meshMitotane
dc.subject.meshPPAR gamma
dc.subject.meshPituitary-Adrenal System
dc.subject.meshSomatostatin
dc.subject.meshSteroids
dc.titlePharmacological management of Cushing's syndrome: an update.en
dc.typeArticleen
dc.contributor.departmentChristie Hospital, Manchester, UK.en
dc.identifier.journalArquivos Brasileiros de Endocrinologia e Metabologiaen
html.description.abstractThe 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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