ACTA ENDOCRINOLOGICA (BUC)

The International Journal of Romanian Society of Endocrinology / Registered in 1938

in Web of Science Master Journal List

Acta Endocrinologica(Bucharest) is live in PubMed Central

Journal Impact Factor - click here.

Year Volume Issue First page
10.4183/aeb.
Author
Title
Abstract/Title
From through

  • Clinical review/Extensive clinical experience

    Chabre O, Cristante J

    Treatment of Cushing’s Syndrome : What Place for Medical Treatment?

    Acta Endo (Buc) 2019 15(2): 237-243 doi: 10.4183/aeb.2019.237

    Abstract
    Surgery plays a major role as a first-line treatment of the different etiologies of Cushing’s syndrome (CS) and bilateral adrenalectomy (BA) is extremely effective as a second line, so that there seems to be little room for medical treatment (MT). However, during the past years several drugs acting either on ACTH secretion or cortisol synthesis have been developed, so that MT of CS might be reassessed. After briefly analyzing the efficiency and tolerance of surgical and medical treatments of CS we try to distinguish consensual and controversial indications for MT. We believe the former include “pre-operative treatment” in rare patients in whom the severity of CS is likely to increase the risks of surgery; “inoperability” for rare patients who cannot be operated even when CS is controlled and “surgical failure or recurrence”, mainly in patients Cushing’s disease (CD) not in remission after TSS. Controversial indications include “unavailability of an expert surgeon”, which we believe does not make sense when the cost of MT is taken into consideration. Finally in patients with the “surgical failure or recurrence” indication the balance between efficacy and side effects of MT should be balanced with the efficacy and side effects of BA.