Abstract
Surgery remains the principal treatment modality in Cushing's disease, but up to half of the patients might need additional treatment because of persistent or recurrent disease during their lifetime. Medical therapy plays an important role in control of hypercortisolemia in patients who are not surgical candidates, who fail remission or develop a recurrence after surgery, or who are critically ill awaiting surgery. Medical therapies for Cushing's disease can be classified into three major categories: pituitary-directed neuromodulators of adrenocorticotropic hormone, adrenal steroidogenesis inhibitors, and glucocorticoid receptor blockers. This chapter reviews the mechanism of action, efficacy, adverse reactions, and role of currently available medications for the treatment of Cushing's disease. Additionally, medications under investigation, use of combination therapies, and treatment of Cushing's disease in special populations, including treatment in pregnancy and acutely ill states of hypercortisolemia, are discussed.
| Original language | English (US) |
|---|---|
| Title of host publication | Cushing's Disease |
| Subtitle of host publication | An Often Misdiagnosed and Not So Rare Disorder |
| Publisher | Elsevier Inc. |
| Pages | 103-123 |
| Number of pages | 21 |
| ISBN (Electronic) | 9780128043905 |
| ISBN (Print) | 9780128043400 |
| DOIs | |
| State | Published - 2017 |
Keywords
- Cabergoline
- Cushing's disease
- Ketoconazole
- Levoketoconazole
- Medical therapy
- Metyrapone
- Mifepristone
- Osilodrostat
- Pasireotide
ASJC Scopus subject areas
- General Medicine