Update on Medical Treatment of Cushing’s Syndrome

Pivonello R, Isidori AM, De Martino MC, Newell-Price J, Biller BMK, Colao A. Complications of Cushing’s syndrome: state of the art. Lancet Diabetes Endocrinol. 2016;4(7):611–29.

Article  CAS  PubMed  Google Scholar 

Nieman LK, Castinetti F, Newell-Price J, Valassi E, Drouin J, Takahashi Y, et al. Cushing syndrome. Nat Rev Dis Prim. 2025;11(1):4.

Article  PubMed  Google Scholar 

Steffensen C, Bak AM, Zøylner Rubeck K, Jørgensen JOL. Epidemiology of cushing’s syndrome. Neuroendocrinology. 2010;92(Suppl 1):1–5.

Article  CAS  PubMed  Google Scholar 

Rubinstein G, Osswald A, Hoster E, Losa M, Elenkova A, Zacharieva S, et al. Time to diagnosis in Cushing’s syndrome: a meta-analysis based on 5367 patients. J Clin Endocrinol Metab. 2020;105(3):e12-22.

Article  Google Scholar 

Hakami OA, Ahmed S, Karavitaki N. Epidemiology and mortality of Cushing’s syndrome. Best Pract Res Clin Endocrinol Metab. 2021;35(1):101521.

Article  CAS  PubMed  Google Scholar 

Pivonello R, Ferrigno R, De Martino MC, Simeoli C, Di Paola N, Pivonello C, et al. Medical treatment of Cushing’s disease: an overview of the current and recent clinical trials. Front Endocrinol (Lausanne). 2020;11:648.

Article  PubMed  Google Scholar 

Nieman LK, Biller BMK, Findling JW, Murad MH, Newell-Price J, Savage MO, et al. Treatment of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(8):2807–31.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Gilis-Januszewska A, Bogusławska A, Rzepka E, Ziaja W, Hubalewska-Dydejczyk A. Individualized medical treatment options in Cushing disease. Front Endocrinol (Lausanne). 2022;13:1060884.

Article  PubMed  Google Scholar 

Fleseriu M, Auchus R, Bancos I, Ben-Shlomo A, Bertherat J, Biermasz NR, et al. Consensus on diagnosis and management of Cushing’s disease: a guideline update. Lancet Diabetes Endocrinol. 2021;9(12):847–75.

Article  PubMed  PubMed Central  Google Scholar 

Feelders RA, Newell-Price J, Pivonello R, Nieman LK, Hofland LJ, Lacroix A. Advances in the medical treatment of Cushing’s syndrome. Lancet Diabetes Endocrinol. 2019;7(4):300–12.

Article  PubMed  Google Scholar 

Feelders RA, Fleseriu M, Kadioglu P, Bex M, González-Devia D, Boguszewski CL, et al. Long-term efficacy and safety of subcutaneous pasireotide alone or in combination with cabergoline in Cushing’s disease. Front Endocrinol (Lausanne). 2023;14:1165681.

Article  PubMed  Google Scholar 

De Bruin C, Feelders RA, Lamberts SWJ, Hofland LJ. Somatostatin and dopamine receptors as targets for medical treatment of Cushing’s syndrome. Rev Endocr Metab Disord. 2009;10(2):91–102.

Article  CAS  PubMed  Google Scholar 

Colao A, Petersenn S, Newell-Price J, Findling JW, Gu F, Maldonado M, et al. A 12-month phase 3 study of pasireotide in Cushing’s disease. N Engl J Med. 2012;366(10):914–24.

Article  CAS  PubMed  Google Scholar 

Pivonello R, Petersenn S, Newell-Price J, Findling JW, Gu F, Maldonado M, et al. Pasireotide treatment significantly improves clinical signs and symptoms in patients with Cushing’s disease: results from a phase III study. Clin Endocrinol (Oxf). 2014;81(3):408–17.

Article  CAS  PubMed  Google Scholar 

Petersenn S, Salgado LR, Schopohl J, Portocarrero-Ortiz L, Arnaldi G, Lacroix A, et al. Long-term treatment of Cushing’s disease with pasireotide: 5-year results from an open-label extension study of a phase III trial. Endocrine. 2017;57(1):156–65.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lacroix A, Gu F, Gallardo W, Pivonello R, Yu Y, Witek P, et al. Efficacy and safety of once-monthly pasireotide in Cushing’s disease: a 12 month clinical trial. Lancet Diabetes Endocrinol. 2018;6(1):17–26.

Article  CAS  PubMed  Google Scholar 

Fleseriu M, Petersenn S, Biller BMK, Kadioglu P, De Block C, T’Sjoen G, et al. Long-term efficacy and safety of once-monthly pasireotide in Cushing’s disease: a phase III extension study. Clin Endocrinol (Oxf). 2019;91(6):776–85.

Article  CAS  PubMed  Google Scholar 

Simeoli C, Auriemma RS, Tortora F, De Leo M, Iacuaniello D, Cozzolino A, et al. The treatment with pasireotide in Cushing’s disease: effects of long-term treatment on tumor mass in the experience of a single center. Endocrine. 2015;50(3):725–40.

Article  CAS  PubMed  Google Scholar 

Fleseriu M, Iweha C, Salgado L, Mazzuco TL, Campigotto F, Maamari R, et al. Safety and efficacy of subcutaneous pasireotide in patients with Cushing’s disease: results from an open-label, multicenter, single-arm, multinational, expanded-access study. Front Endocrinol (Lausanne). 2019;10:436.

Article  PubMed  Google Scholar 

Colao A, De Block C, Gaztambide MS, Kumar S, Seufert J, Casanueva FF. Managing hyperglycemia in patients with Cushing’s disease treated with pasireotide: medical expert recommendations. Pituitary. 2014;17(2):180–6.

Article  CAS  PubMed  Google Scholar 

Samson SL, Gu F, Feldt-Rasmussen U, Zhang S, Yu Y, Witek P, et al. Managing pasireotide-associated hyperglycemia: a randomized, open-label, phase IV study. Pituitary. 2021;24(6):887–903.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Pivonello R, Pivonello C, Simeoli C, De Martino MC, Colao A. The dopaminergic control of Cushing’s syndrome. J Endocrinol Investig. 2022;45(7):1297–315.

Article  CAS  Google Scholar 

Pivonello R, De Martino MC, Cappabianca P, De Leo M, Faggiano A, Lombardi G, et al. The medical treatment of Cushing’s disease: effectiveness of chronic treatment with the dopamine agonist cabergoline in patients unsuccessfully treated by surgery. J Clin Endocrinol Metab. 2009;94(1):223–30.

Article  CAS  PubMed  Google Scholar 

Lila AR, Gopal RA, Acharya SV, George J, Sarathi V, Bandgar T, et al. Efficacy of cabergoline in uncured (persistent or recurrent) Cushing disease after pituitary surgical treatment with or without radiotherapy. Endocr Pract. 2010;16(6):968–76.

Article  PubMed  Google Scholar 

Vilar L, Naves LA, Azevedo MF, Arruda MJ, Arahata CM, Moura e Silva L, et al. Effectiveness of cabergoline in monotherapy and combined with ketoconazole in the management of Cushing’s disease. Pituitary. 2010;13(2):123–9.

Article  CAS  PubMed  Google Scholar 

Godbout A, Manavela M, Danilowicz K, Beauregard H, Bruno OD, Lacroix A. Cabergoline monotherapy in the long-term treatment of Cushing’s disease. Eur J Endocrinol. 2010;163(5):709–16.

Article  CAS  PubMed  Google Scholar 

Barbot M, Albiger N, Ceccato F, Zilio M, Frigo AC, Denaro L, et al. Combination therapy for Cushing’s disease: effectiveness of two schedules of treatment: should we start with cabergoline or ketoconazole? Pituitary. 2014;17(2):109–17.

Article  CAS  PubMed  Google Scholar 

Burman P, Edén-Engström B, Ekman B, Karlsson FA, Schwarcz E, Wahlberg J. Limited value of cabergoline in Cushing’s disease: a prospective study of a 6-week treatment in 20 patients. Eur J Endocrinol. 2016;174(1):17–24.

Article  CAS  PubMed  Google Scholar 

Ferriere A, Cortet C, Chanson P, Delemer B, Caron P, Chabre O, et al. Cabergoline for Cushing’s disease: a large retrospective multicenter study. Eur J Endocrinol. 2017;176(3):305–14.

Article  CAS  PubMed  Google Scholar 

Palui R, Sahoo J, Kamalanathan S, Kar SS, Selvarajan S, Durgia H. Effect of cabergoline monotherapy in Cushing’s disease: an individual participant data meta-analysis. J Endocrinol Investig. 2018;41(12):1445–55.

Article  CAS  Google Scholar 

Palui R, Sahoo J, Kamalanathan S, Kar SS, Selvarajan S, Durgia H, et al. Effect of cabergoline monotherapy in Cushing’s disease: an individual participant data meta-analysis. J Endocrinol Investig. 2018;41(12):1445–55. https://doi.org/10.1007/s40618-018-0936-7.

Article  CAS 

Comments (0)

No login
gif