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Exp Clin Endocrinol Diabetes 2024; 132(12): 723-731
DOI: 10.1055/a-2317-0801
Review

Medical Therapy of Endogenous Cushing’s Syndrome with Steroidogenesis Inhibitors: Treatment Rationale, Available Drugs, and Therapeutic Effects

Mario Detomas
1   Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
,
Timo Deutschbein
1   Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
2   Medicover Oldenburg MVZ, Oldenburg, Germany
,
Barbara Altieri
1   Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
› Institutsangaben Funding information MD was supported by the Clinician Scientist program RISE, funded by the Else-Kröner-Fresenius-Stiftung and the Eva-Luise und Horst-Köhler Stiftung.
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Abstract

Endogenous Cushing’s syndrome (CS) is a rare disease characterized by a glucocorticoid excess. If inadequately treated, hypercortisolism can lead to increased morbidity and mortality. Surgical removal of the underlying tumor is the first-line treatment but is sometimes not feasible or even contraindicated. Additionally, in cases with severe CS, rapid control of hypercortisolism may be required. In these scenarios, steroidogenesis inhibitors represent a therapeutic alternative to surgery. Over the last years, the knowledge of the broad therapeutic effects of steroidogenesis inhibitors per se and the number of available drugs have increased. However, large comparative studies are still lacking. Accordingly, the decision on which drug to be used in a certain patient or clinical setting may be difficult. This review aims to summarize the main characteristics of steroidogenesis inhibitors.

Keywords

etomidate - hypercortisolism - ketoconazole - levoketoconazole - medical therapy - metyrapone - mitotane - osilodrostat


Publikationsverlauf

Eingereicht: 01. Februar 2024
Eingereicht: 18. April 2024

Accepted Manuscript online:
30. April 2024

Artikel online veröffentlicht:
14. Juni 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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