eISSN: 2449-8580
ISSN: 1734-3402
Family Medicine & Primary Care Review
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2/2023
vol. 25
 
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abstract:
Review paper

Steroidogenesis inhibitors in the treatment of nonoperative Cushing’s syndrome – a literature review

Magdalena Kamińska
1
,
Adam Strzoda
2
,
Anna Strzoda
2
,
Agata Strzoda
3
,
Wojciech Sowiński
2
,
Michał Zdybel
2
,
Agata Juda
2
,
Kornelia Rojek
2
,
Agnieszka Polak
1

  1. Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Lublin, Poland
  2. Student Scientific Society at Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Lublin, Poland
  3. Salus Aegroti Student Scientific Society at Departament of Physiology, Faculty of Medicine of Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
Family Medicine & Primary Care Review 2023; 25(2): 212–216
DOI: https://doi.org/10.5114/fmpcr.2023.127682
Online publish date: 2023/06/26
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Background
Cushing’s syndrome (CS) is a disorder caused by excess cortisol production. It is three times more often seen in female than male patients, and overall, it is observed in 2–3 per million/year. In nearly 70% of cases, this is due to a pituitary tumour secreting adrenocorticotropic hormones. The first-line approach to treat these cases is the surgical removal of the tumour. However, in nearly a quarter of cases, this proves ineffective. These patients should be then treated with pharmacotherapy, while untreated CS may be lethal. The most numerous groups of pharmaceutics in CS treatment are steroidogenesis inhibitors.

Objectives
The purpose of this article is to review the latest publications from 2015 to 2022, which state the medical approach with steroidogenesis inhibitors to inoperative CS, the advantages, as well potential burdens and adverse effects of this pharmacological treatment.

Material and methods
A review of literature regarding adrenal steroidogenesis inhibitors was performed using the PubMed database; the search terms Cushing’s syndrome, inoperative, ketoconazole, levoketoconazole, metyrapone, mitotane, etomidate, and osilodrostat were applied.

Results and conclusions
This review states the current data pertaining to the effectiveness of hypercortisolaemia treatment, as well as the potential adverse effects of ketoconazole, levoketoconazole, metyrapone, mitotane, etomidate, osilodrostat – steroidogenesis inhibitors currently used in the therapy of nonoperative Cushing’s syndrome.

keywords:

pituitary ACTH hypersecretion, Cushing syndrome, steroids, review

  
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