Consensus on diagnosis and management of Cushing's disease: a guideline update

Maria Fleseriu, Richard Auchus, Irina Bancos, Anat Ben-Shlomo, Jerome Bertherat, Nienke R. Biermasz, Cesar L. Boguszewski, Marcello D. Bronstein, Michael Buchfelder, John D. Carmichael, Felipe F. Casanueva, Frederic Castinetti, Philippe Chanson, James Findling, Mônica Gadelha, Eliza B. Geer, Andrea Giustina, Ashley Grossman, Mark Gurnell, Ken HoAdriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Daniel F. Kelly, André Lacroix, Ann McCormack, Shlomo Melmed, Mark Molitch, Pietro Mortini, John Newell-Price, Lynnette Nieman, Alberto M. Pereira, Stephan Petersenn, Rosario Pivonello, Hershel Raff, Martin Reincke, Roberto Salvatori, Carla Scaroni, Ilan Shimon, Constantine A. Stratakis, Brooke Swearingen, Antoine Tabarin, Yutaka Takahashi, Marily Theodoropoulou, Stylianos Tsagarakis, Elena Valassi, Elena V. Varlamov, Greisa Vila, John Wass, Susan M. Webb, Maria C. Zatelli, Beverly M.K. Biller

Research output: Contribution to journalReview articlepeer-review

280 Scopus citations


Cushing's disease requires accurate diagnosis, careful treatment selection, and long-term management to optimise patient outcomes. The Pituitary Society convened a consensus workshop comprising more than 50 academic researchers and clinical experts to discuss the application of recent evidence to clinical practice. In advance of the virtual meeting, data from 2015 to present about screening and diagnosis; surgery, medical, and radiation therapy; and disease-related and treatment-related complications of Cushing's disease summarised in recorded lectures were reviewed by all participants. During the meeting, concise summaries of the recorded lectures were presented, followed by small group breakout discussions. Consensus opinions from each group were collated into a draft document, which was reviewed and approved by all participants. Recommendations regarding use of laboratory tests, imaging, and treatment options are presented, along with algorithms for diagnosis of Cushing's syndrome and management of Cushing's disease. Topics considered most important to address in future research are also identified.

Original languageEnglish (US)
Pages (from-to)847-875
Number of pages29
JournalThe Lancet Diabetes and Endocrinology
Issue number12
StatePublished - Dec 2021

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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