Endocrine Abstracts

Background: The use of intra-articular (IA) glucocorticoids for reducing pain and inflammation in patients with osteoarthritis, rheumatoid arthritis, and other inflammatory arthropathies is widespread among primary care physicians, specialists and non-specialists in the United States. Injectable glucocorticoids have anti-inflammatory and analgesic properties which can be effective in improving clinical parameters such as pain, range of motion, and quality of life. After inject...

Background: Ectopic pituitary adenomas are defined by the presence of adenomatous pituitary tissue outside the sella and distinctly separate from the pituitary gland. Ectopic ACTH-secreting pituitary adenomas (EAPAs) are a rare cause of Cushing’s syndrome. Detecting these radiologically can prove difficult, in part, due to their typically small size and unpredictable anatomical location.Aim: We reviewed the current literature on all previously repor...

Clinical presentation: We report a 46 year old female who presented with a 1 year history of bruising, thin skin and weight gain. In addition; she reported flushing of her chest, heat intolerance, palpitations and abdominal pain. On clinical examination she appeared cushingoid, blood pressure was elevated at 160/98 mm/Hg.Investigations: Biochemical investigations indicated ACTH-dependent Cushing syndrome: 24 h UFC 300 μg (0–50), ACTH 119 pg/ml ...

Background: Transsphenoidal tumour resection (TSS) is the first-line treatment for Cushing’s disease (CD). With an experienced neurosurgeon, immediate remission rates >80% are expected for patients with microadenomas (<10 mm).Aim: To report initial and long-term remission rates in a specialist centre, and to ascertain factors associated with disease recurrence after TSS.Methods: Patients with CD (n=101, 28M, 7...

Background: Successful pituitary surgery in patients with Cushing disease (CD) can result in long term remission and sustained weight loss. We examined rates of body weight changes in the post-operative period (within 6 months) in patients with active CD who underwent transsphenoidal surgery (TSS) and the relationship of weight loss to remission status.Methods: Clinical data was obtained from a CD database in addition to an online patient medical record ...

Background: Cushing’s disease is a condition rarely encountered during pregnancy. It is known that hypercortisolism is associated with increased maternal and foetal morbidity and mortality.Aims and methods: A comprehensive search of the literature was performed for cases of Cushing’s disease in pregnancy including our own case. Analysis was performed of all pregnant patients with Cushing’s disease who were treated with surgery compared to ...

Background: Most cases of Cushing’s disease originate from the pituitary, rarely the source of excess ACTH is from an ectopic pituitary adenoma.Case: A 34-year-old woman had a 12-month history of a labile mood, weight gain, easy bruising, irregular menses and hypertension, she appeared cushingoid. Biochemical investigations demonstrated hypercortisolism: 24 h urine-free cortisol 520.7 μg (4–50), ACTH 152 pg/ml (8–42); midnight salivar...

Background: Many patients with acromegaly report limitations of long-acting somatostatin receptor ligand (SRL) injections, including ongoing disease symptoms near cycle-end and injection-site pain. Oral octreotide capsules (OOC) may provide an alternative to monthly injections. The phase 3 CHIASMA OPTIMAL study assessed efficacy and safety of OOC in patients with acromegaly controlled on injectable SRLs.Methods: A multinational, randomized, placebo-contr...

Background: Injectable somatostatin receptor ligands (SRLs) are currently the most widely used therapy for acromegaly. Oral octreotide capsules (OOC) are a potential therapy for acromegaly; the safety and efficacy were evaluated in the CHIASMA OPTIMAL pivotal study (Samson et al. ENDO 2020). As reported, mean IGF-I levels of the OOC group were maintained within normal range at end of treatment in all patients. However, some patients may not respond to OOC treatment (2...

Background: Oral octreotide capsules (OOC) are a treatment option for patients with acromegaly in the United States who have previously responded to injectable somatostatin receptor ligands (iSRLs, octreotide or lanreotide). In previous phase 3 studies, the safety of OOC was shown to be consistent with iSRLs, without dose-dependent adverse reactions. In the double-blind, placebo-controlled period (DPC) of the CHIASMA OPTIMAL trial (NCT03252353), patients were randomized to twi...