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Biochemical Control in Cushing's syndrome: Outcomes of the treatment in a large single center cohort.
Ritzel, Katrin; Fazel, Julia; August, Leah; Fedtke, Vanessa; Nowak, Elisabeth; Vogel, Frederick; Braun, Leah; Zopp, Stephanie; Then, Cornelia; Künzel, Heike; Reisch, Nicole; Zimmermann, Petra; Thorsteinsdottir, Jun; Schopohl, Jochen; Bidlingmaier, Martin; Beuschlein, Felix; Reincke, Martin; Rubinstein, German.
Afiliação
  • Ritzel K; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Fazel J; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • August L; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Fedtke V; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Nowak E; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Vogel F; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Braun L; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Zopp S; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Then C; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Künzel H; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Reisch N; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Zimmermann P; Department of General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich.
  • Thorsteinsdottir J; Department of Neurosurgery, LMU University Hospital, LMU Munich.
  • Schopohl J; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Bidlingmaier M; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Beuschlein F; Department of Medicine IV, LMU University Hospital, LMU Munich.
  • Reincke M; Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich (USZ), and University of Zurich (UZH), Switzerland.
  • Rubinstein G; The LOOP Zurich - Medical Research Center, Zurich, Switzerland.
Article em En | MEDLINE | ID: mdl-38767080
ABSTRACT

BACKGROUND:

Normalization of hypercortisolism is essential to reduce morbidity and mortality in patients with Cushing's syndrome (CS). The aim of this analysis was to assess biochemical control rates in patients with Cushing's disease (CD), ectopic Cushing's syndrome (ECS) and adrenal Cushing's syndrome (ACS).

METHODS:

Patients with confirmed CS (n= 296) treated in a single tertiary care center were retrospectively analysed (185 CD, 27 ECS, 84 uni- and bilateral ACS).

RESULTS:

Firstline treatment led to biochemical control in 82% of the patients. Time to biochemical control (median, IQR) was longer in CD (11.0 weeks, 5.6-29.8; p< 0.05) than in ACS (7.7 weeks, 4.1-17.1) and ECS (5.6 weeks, 4.1-23.3). Disease persistence or recurrence after first-line therapy was observed more often in CD (24% and 18%; p< 0.05) than in ECS (15% and 15%) and ACS (6% and 4%). Total time in hypercortisolism since diagnosis was significantly shorter in patients with CD diagnosed since 2013, after specialized patient care was implemented, compared to patients diagnosed before 2013 (13.5 weeks, vs. 26.1 weeks; p< 0.0070). Control of hypercortisolism at last follow up (76 months, 38-163) was achieved in 94% of patients with ACS, 100% of patients with ECS and 92% of patients with CD.

CONCLUSIONS:

Biochemical control can be achieved in most patients with different subtypes of CS within a reasonable time frame. Control of hypercortisolism has improved over time.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article