Medical Management of Cushing’s Syndrome

Current and Emerging Treatments

José Miguel Hinojosa-Amaya, Daniel Cuevas-Ramos, Maria Fleseriu

Research output: Contribution to journalReview article

Abstract

Endogenous Cushing’s syndrome is a chronic disease associated with increased morbidity and mortality if not appropriately treated. Recurrence and/or persistence of hypercortisolemia after surgical treatment, especially for Cushing’s disease, are high, and long-term medical treatment is used to decrease cortisol levels and risk of metabolic comorbidities. Medical treatment is also often required while waiting for radiation effects to take place. In some cases, severe or life-threatening hypercortisolism must be urgently and medically treated, via intravenous medications or with combination therapy, before patients can undergo surgery. In the last decade, medical treatment has progressed from a few steroidogenesis inhibitors to three novel drug groups: new inhibitors for steroidogenic enzymes with possibly fewer side effects, pituitary-directed drugs that aim to inhibit the pathophysiological pathways of Cushing’s disease, and glucocorticoid receptor antagonists that block cortisol’s action. Understanding the pathophysiology of Cushing’s syndrome has also led to the identification of potential targets that may decrease adrenocorticotrophic hormone and/or cortisol excess, and/or decrease tumor cell proliferation, and induce senescence or apoptosis. We provide here a review of current and near-future medical options to treat Cushing’s syndrome, and discuss updates on clinical trials and the efficacy and safety of novel or in-development drugs, as well as future potential targets.

Original languageEnglish (US)
JournalDrugs
DOIs
StatePublished - Jan 1 2019

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Cushing Syndrome
Hydrocortisone
Pituitary ACTH Hypersecretion
Pharmaceutical Preparations
Therapeutics
Radiation Effects
Glucocorticoid Receptors
Enzyme Inhibitors
Adrenocorticotropic Hormone
Comorbidity
Chronic Disease
Cell Proliferation
Clinical Trials
Apoptosis
Morbidity
Safety
Recurrence
Mortality
Neoplasms

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Medical Management of Cushing’s Syndrome : Current and Emerging Treatments. / Hinojosa-Amaya, José Miguel; Cuevas-Ramos, Daniel; Fleseriu, Maria.

In: Drugs, 01.01.2019.

Research output: Contribution to journalReview article

Hinojosa-Amaya, José Miguel ; Cuevas-Ramos, Daniel ; Fleseriu, Maria. / Medical Management of Cushing’s Syndrome : Current and Emerging Treatments. In: Drugs. 2019.
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