SynthesisPituitary2018
Effectiveness of medical treatment for Cushing's syndrome: a systematic review and meta-analysis.
Synthesis in Pituitary, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses 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
43 citing papers in PubMed, 3 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Ketoconazole as second-line treatment for Cushing's disease after transsphenoidal surgery: systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Effectiveness of Medical Treatment of Cushing's Disease: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- Recurrence after pituitary surgery in adult Cushing's disease: a systematic review on diagnosis and treatment.Endocrine · 2020Pooled it
- Randomized Trial of Osilodrostat for the Treatment of Cushing Disease.The Journal of clinical endocrinology and metabolism · 2022Trial
- International real-world study on osilodrostat efficacy and safety in adrenal Cushing syndrome.The Journal of clinical endocrinology and metabolism · 2026Article
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Review
- Real-World Data on the Efficacy and Safety of Osilodrostat in Patients with Cushing's Disease in Spain.Journal of clinical medicine · 2025Article
- Review
- Results for LINAC-based radiosurgery or fractionated stereotactic radiotherapy for corticotropic pituitary tumors: a single-center retrospective cohort.Journal of endocrinological investigation · 2025Article
- Cardiometabolic complications after Cushing's disease remission.Journal of endocrinological investigation · 2025Observational
- Medical Treatment of Cushing's Syndrome.Endocrinology and metabolism (Seoul, Korea) · 2025Review
- Surgical Treatment of Cushing's Disease: The Lessons Learned.Advances and technical standards in neurosurgery · 2025Review
- Drug induced hypoprolactinemia.Reviews in endocrine & metabolic disorders · 2024Review
- New Trends in Treating Cushing's Disease.TouchREVIEWS in endocrinology · 2024Article
- [A diagnostic maze: Cushing's disease].Innere Medizin (Heidelberg, Germany) · 2024Article
- Medical treatment of functional pituitary adenomas, trials and tribulations.Journal of neuro-oncology · 2024Review
- Safe long-term therapy of Cushing's syndrome over 37 years with mitotane.Frontiers in endocrinology · 2024Review
- Metyrapone single administration, as a possible predictive tool of its dosage and timing in Cushing's syndrome.Frontiers in endocrinology · 2024Observational
- Budget impact analysis of cabergoline for medical treatment of Cushing's disease in Brazil.Archives of endocrinology and metabolism · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo systematically review the effectiveness of medical treatment for Cushing's syndrome in clinical practice, regarding cortisol secretion, clinical symptom improvement, and quality of life. To assess the occurrence of side effects of these medical therapies.
methodsEight electronic databases were searched in March 2017 to identify potentially relevant articles. Randomized controlled trials and cohort studies assessing the effectiveness of medical treatment in patients with Cushing's syndrome, were eligible. Pooled proportions were reported including 95% confidence intervals.
resultsWe included 35 articles with in total 1520 patients in this meta-analysis. Most included patients had Cushing's disease. Pooled reported percentage of patients with normalization of cortisol ranged from 35.7% for cabergoline to 81.8% for mitotane in Cushing's disease. Patients using medication monotherapy showed a lower percentage of cortisol normalization compared to use of multiple medical agents (49.4 vs. 65.7%); this was even higher for patients with concurrent or previous radiotherapy (83.6%). Mild side effects were reported in 39.9%, and severe side effects were seen in 15.2% of patients after medical treatment. No meta-analyses were performed for clinical symptom improvement or quality of life due to lack of sufficient data.
conclusionsThis meta-analysis shows that medication induces cortisol normalization effectively in a large percentage of patients. Medical treatment for Cushing's disease patients is thus a reasonable option in case of a contraindication for surgery, a recurrence, or in patients choosing not to have surgery. When experiencing side effects or no treatment effect, an alternate medical therapy or combination therapy can be considered.
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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.