Endocrine Abstracts

Background: Osilodrostat is an oral inhibitor of 11β-hydroxylase (CYP11B1), the enzyme that catalyses the final step in cortisol biosynthesis. In a 22-week, phase II study, osilodrostat treatment normalised mean urinary free cortisol (mUFC) in 78.9% (15/19) of patients with uncontrolled Cushing’s disease and was well tolerated. The present phase 3 study is designed to confirm the safety and efficacy of osilodrostat in patients with uncontrolled Cushing’s disease...

Cushing’s syndrome (CS) during pregnancy is a rare metabolic condition with only a few cases reported in the literature. Misdiagnosis of CS is common because of the overlapping features of fatigue, weight gain, striae, and emotional changes that occur during normal pregnancy. The clinical presentation together with laboratory and imaging findings help to make a diagnosis. However, changes in maternal hormones and their binding proteins complicate assessment of the normal ...

Background: Dopamine and somatostatin receptors on corticotroph pituitary adenomas are targets for medical treatment of Cushing’s disease (CD). Data indicate synergistic effects between pasireotide and cabergoline in improving biochemical control rates and clinical features in patients with CD.Objective: To evaluate safety and efficacy of pasireotide alone or with cabergoline in patients with CD.Methods: Patients: adults with ...

The ERCUSYN (European Registry on Cushing’s syndrome (CS)) study is a project funded by the European Commission Public Health Program (PHP 800200), of which the ESE is one of the 41 Partners from 25 countries. The aims include obtaining prospective and follow-up data at EU level on epidemiology, mortality, outcome of therapies, co-morbidities, assessment of diagnostic and therapeutic strategies, quality of life evaluation using a disease-generated questionnaire (CushingQo...

Objective: To assess if weekly administration of 40 mg pegvisomant (PEG-V) improves quality of life (QoL) and metabolic parameters in acromegalic patients with already normal age-adjusted insulin-like growth factor-I (IGF-I) concentrations during long-acting somatostatin analog (SSA) treatment.Design: Prospective investigator-initiated, double blind, placebo controlled, cross-over study. Twenty acromegalic subjects received for two consecutive treatment ...

Background: We previously reported on the efficacy, safety and Quality of Life of long-acting somatostatin analogs (SSA) and (twice) weekly pegvisomant (PEG-V) in acromegaly and improvement after the addition of PEG-V to long-acting SSA.Objective: To assess the long term safety in a larger group of acromegalic patients over a larger period of time; 29.2 (1.2–57.4) months (mean (range)).Design: Pegvisomant was added to SSA mono...

Objective: Treatment with ergot-derived dopamine agonists, pergolide and cabergoline, has been associated with an increased frequency of valvular heart disease in Parkinson’s disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated with dopamine agonists for prolactinomas.Design: Cross-sectional study.Patients: We performed conventional two-dimensional and Doppler echocar...

Background: Cortisol has a suppressive effect on corticotroph proliferation. In Cushing’s disease (CD), the relative resistance to glucocorticoid (GC) action may favor corticotroph tumor formation and autonomous ACTH secretion.Objective: To analyze the consequences of long-term GC exposure on corticotroph tumor cell proliferation and to evaluate the modification of gene expression attributable to prolonged GC treatment.Methods...

Background: 24-h mean urinary free cortisol (mUFC) and late-night salivary cortisol (LNSC) levels are complementary parameters recommended for screening and monitoring treatment response in patients with Cushing’s disease (CD). In the published core period of the Phase III LINC 3 study (NCT02180217), therapy with osilodrostat (potent oral 11β-hydroxylase inhibitor) produced rapid, sustained reductions in mUFC and LNSC alongside improvements in clinical signs of hyper...

Background: Small functional pituitary adenomas can cause severely disabling symptoms and early death, however, surgical planning is often complicated due to inconclusive diagnostic MRI in up to 40% of patients and therefore hamper cure rates. We here introduce a novel method for the detection of small functional pituitary adenoma by O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET) PET-MRI.Methods: Patients with Cushing’s disease (CD) or acromegaly wit...