Successful Treatment of Cushing’s Syndrome with the Glucocorticoid Antagonist RU 486

Lynnette K. Nieman, George P. Chrousos, Charles Kellner, Irving M. Spitz, Bruce C. Nisula, Gordon B. Cutler, George R. Merriam, C. Wayne Bardin, D. Lynn Loriaux

Research output: Contribution to journalArticle

283 Scopus citations

Abstract

A patient with Cushings syndrome due to ectopic ACTH secretion was treated successfully with the new glucocorticoid antagonist RU 486 [17β3-hydroxy-llβ-(4-dimethylamino phenyl)17α-(l-propynyl)estra-4, 9-dien-3-one]. This compound is a 19-nor steroid with substitutions at positions Cll and G17 which antagonizes cortisol action competitively at the receptor level. Oral RU 486 was given in increasing doses of 5, 10, 15, and 20 mg/kg- day for a 9-week period. Treatment eficacy was monitored by assessment of clinical status and by measuring several glucocorticoid-sensitive variables, including fasting blood sugar, blood sugar 120 min after oral glucose administration, and plasma concentrations of TSH, corticosteroid-binding globulin, LH, testosterone-estradiol-binding globulin, and total and free testosterone. With therapy, the somatic features of Cushing’s syndrome (buffalo hump, central obesity, and moon facies) ameliorated, mean arterial blood pressure normalized, suicidal depression resolved, and libido returned. All biochemical glucocorticoid- sensitive parameters normalized. No side-effects of drug toxicity were observed. We conclude that RU 486 may provide a safe, well tolerated, and effective medical treatment for hypercortisolism.

Original languageEnglish (US)
Pages (from-to)536-540
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume61
Issue number3
DOIs
StatePublished - Sep 1985

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Nieman, L. K., Chrousos, G. P., Kellner, C., Spitz, I. M., Nisula, B. C., Cutler, G. B., Merriam, G. R., Bardin, C. W., & Loriaux, D. L. (1985). Successful Treatment of Cushing’s Syndrome with the Glucocorticoid Antagonist RU 486. Journal of Clinical Endocrinology and Metabolism, 61(3), 536-540. https://doi.org/10.1210/jcem-61-3-536