ReviewDrugs2016
Therapeutic Strategies for the Treatment of Severe Cushing's Syndrome.
Review in Drugs, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2024Pooled it
- Cyclical ectopic Cushing's syndrome due to a mediastinal neuroendocrine tumor: a case-based review.Irish journal of medical science · 2026Review
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Ectopic Cushing Syndrome Due to a Large Mediastinal Neuroendocrine Tumor.JCEM case reports · 2026Article
- Article
- Update in the Management of ACTH-Secreting Gastroenteropancreatic and Thoracic Neuroendocrine Neoplasms.Current treatment options in oncology · 2025Review
- Real-World Data on the Efficacy and Safety of Osilodrostat in Patients with Cushing's Disease in Spain.Journal of clinical medicine · 2025Article
- New Trends in Treating Cushing's Disease.TouchREVIEWS in endocrinology · 2024Article
- A case of gallbladder neuroendocrine carcinoma complicated by ectopic adrenocorticotropic hormone syndrome and resulting in rapid fetal outcomes due to sepsis.Clinical journal of gastroenterology · 2024Article
- Case Report: Opposite Tumoral and Hormonal Responses to Low-dose Pasireotide in Cushing's Disease.Endocrine, metabolic & immune disorders drug targets · 2024Article
- Severe Cushing's syndrome from an ectopic adrenocorticotropic hormone-secreting neuroendocrine tumour treated by osilodrostat.Endocrinology, diabetes & metabolism case reports · 2023Article
- Efficacy and Safety of Osilodrostat in Paraneoplastic Cushing Syndrome: A Real-World Multicenter Study in France.The Journal of clinical endocrinology and metabolism · 2023Article
- Cushing's syndrome: a combined treatment with etomidate and osilodrostat in severe life-threatening hypercortisolemia.Hormones (Athens, Greece) · 2022Review
- Using Etomidate in a Two-month-old Infant with Cushing Syndrome due to Adrenocortical CarcinomaJournal of clinical research in pediatric endocrinology · 2022Article
- Evaluation of ketoconazole as a treatment for Cushing's disease in a retrospective cohort.Frontiers in endocrinology · 2022Article
- Old Problem, New Concerns: Hypercortisolemia in the Time of COVID-19.Frontiers in endocrinology · 2021Review
- Severe ectopic Cushing's syndrome.Proceedings (Baylor University. Medical Center) · 2020Article
- Fluconazole treatment in severe ectopic Cushing syndromeEndocrinology, diabetes & metabolism case reports · 2019Article
- Review
- TSP-1 is downregulated and inversely correlates with miR-449c expression in Cushing's disease.Journal of cellular and molecular medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Severe Cushing's syndrome presents an acute emergency and is defined by massively elevated random serum cortisol [more than 36 μg/dL (1000 nmol/L)] at any time or a 24-h urinary free cortisol more than fourfold the upper limit of normal and/or severe hypokalaemia (<3.0 mmol/L), along with the recent onset of one or more of the following: sepsis, opportunistic infection, intractable hypokalaemia, uncontrolled hypertension, heart failure, gastrointestinal haemorrhage, glucocorticoid-induced acute psychosis, progressive debilitating myopathy, thromboembolism or uncontrolled hyperglycaemia and ketocacidosis. Treatment focuses on the management of the severe metabolic disturbances followed by rapid resolution of the hypercortisolaemia, and subsequent confirmation of the cause. Emergency lowering of the elevated serum cortisol is most rapidly achieved with oral metyrapone and/or ketoconazole; if parenteral therapy is required then intravenous etomidate is rapidly effective in almost all cases, but all measures require careful supervision. The optimal order and combination of drugs to treat severe hypercortisolaemia-mostly in the context of ectopic ACTH-secreting syndrome, adrenocortical carcinoma or an ACTH-secreting pituitary adenoma (mainly macroadenomas)-is not yet established. Combination therapy may be useful not only to rapidly control cortisol excess but also to lower individual drug dosages and consequently the possibility of adverse effects. If medical treatments fail, bilateral adrenalectomy should be performed in the shortest possible time span to prevent the debilitating complications of uncontrolled hypercortisolaemia.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.