Endocrine Abstracts

Introduction: Metyrapone blocks cortisol production by inhibiting 11ß-hydroxylation of 11-deoxycortisol, the last step of cortisol synthesis. Based on observational retrospective studies published over more than 50 years metyrapone is approved for the treatment of endogenous Cushing’s syndrome (CS) in 14 European countries. PROMPT is the first prospective study to document the safety and efficacy of metyrapone using modern assay techniques.Desi...

IntroductionOsilodrostat, a potent oral 11β-hydroxylase inhibitor, normalized mean urinary free cortisol (mUFC) in most patients with CD during the 48-week (W) core phase of a Phase III study (LINC3: NCT02180217). We present efficacy and safety results following an extension to LINC3.MethodsCD patients with mUFC > 1.5× upper limit of normal (ULN) received osilodrostat during the core. Patients b...

Introduction: Subcutaneous (sc) pasireotide effectively reduces cortisol levels and is generally well tolerated in Cushing’s disease (CD) patients, as demonstrated by a Phase III study (NCT00434148). We report data from a non-interventional, multinational study (NCT02310269) evaluating long-term safety and efficacy of pasireotide sc for CD patients.Methods: Adults with CD, for whom surgery has failed or is not an option, were analysed by time of pas...

The glucose-dependent insulinotropic polypeptide receptor (GIPR) is a 7-transmembrane class B G-protein coupled receptor that mediates the incretin response after nutrient stimulation. Although mostly involved in metabolic disorders, in the last years an improper activation of the GIP/GIPR axis has been increasingly recognized in endocrine tumors, with a potential diagnostic and prognostic value. In Medullary Thyroid Cancer (MTC), a neuroendocrine tumor of the parafollicular C...

During the spring of 2020, a national lockdown was adopted in Italy to prevent COVID-19 pandemic spread. Restrictive measures have been associated with impaired psychological outcome in the general population. As patients with Cushing’s Syndrome (CS), including Cushing’s disease (CD), adrenal CS (ACS), and ectopic CS (ECS), are reportedly associated with a higher prevalence of anxiety, stress susceptibility, depression, and maniac episodes, during both active disease...

Background and objective: Mitotane is the main option of treatment for advanced adrenocortical carcinoma (ACC). However, limited evidence is available regarding practical management of mitotane treatment and its eventual combination with chemotherapy or radiotherapy. The aim of the study is to do a survey on the use of mitotane for advanced ACC in expert Italian centers, analyzing data of the LYSOSAFE database.Methods: Retrospective analysis of patients ...

A recent phase III clinical trial has demonstrated that the treatment with the somatostatin analogue pasireotide normalizes cortisol secretion in 15–28% of patients with Cushing’s disease (CD). The aim of the current study was to evaluate the effectiveness of 6-months pasireotide treatment on clinical and hormonal profiles in a group of CD patients with mild to moderate disease according with the real-word evidence. Thirty-two patients with CD unsuccessfully treated ...

Introduction: Available literature on series of patients affected by ectopic Cushing’s syndrome (ECS) deriving from neuroendocrine tumours (NETs) is relatively scarce. This is the first Italian multicentre study regarding clinicopathologic features, modalities of treatment, and survival of patients with NETs and ECS.Patients and methods: Retrospective analysis of data from patients with ECS from NETs collected in 14 centres between 1986 and 2014, ob...

Background: Glucocorticoids (GC) are potent entrainers of the circadian clock, however their effect on biological rhythms in human chronic exposure have been poorly studied. Endogenous hypercortisolism (Cushing’s Syndrome, CS) is a rare condition, in which circadian disruption is sustained by a tumorous source of GC excess, offering the unique opportunity to investigate the in vivo chronic effects of GC.Methods: In a 12-month prospective mu...

Over the last two years, COVID-19 outbreak and lockdown have exerted a remarkable psychological burden in the general population. Such an impact is supposed to be even worse in acromegaly, known to induce a severe psychological impairment due to its somatic disfigurements and systemic comorbidities. The current observational study aimed at investigating the impact of COVID-19 outbreak and lockdown on psychological health in acromegalic patients as compared to non-acromegalic h...