ArticleEndocrine2018
Metyrapone treatment in Cushing's syndrome: a real-life study.
Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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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
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Effectiveness of Medical Treatment of Cushing's Disease: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- Prospective study of metyrapone in endogenous Cushing's syndrome (PROMPT).European journal of endocrinology · 2025Trial
- Randomized Trial of Osilodrostat for the Treatment of Cushing Disease.The Journal of clinical endocrinology and metabolism · 2022Trial
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Effects of short-term metyrapone treatment on glycaemic control in patients with mild autonomous cortisol secretion: a pilot study.Endocrine · 2026Article
- "Feeding the Rhythm"-Effects of Food and Nutrients on Daily Cortisol Secretion: From Molecular Mechanisms to Clinical Impact.International journal of molecular sciences · 2025Review
- Review
- Efficacy and Hepatotoxicity During Rapid Titration of Ketoconazole and/or Metyrapone in Patients With Cushing Syndrome.Journal of the Endocrine Society · 2025Article
- Cardiometabolic complications after Cushing's disease remission.Journal of endocrinological investigation · 2025Observational
- Molecular and Genetics Perspectives on Primary Adrenocortical Hyperfunction Disorders.International journal of molecular sciences · 2024Review
- Current and Emerging Pharmacological Therapies for Cushing's Disease.Current pharmaceutical design · 2024Review
- Unmet needs on the current medical management of Cushing's syndrome: results from a Delphi panel of Italian endocrinologists.Journal of endocrinological investigation · 2023Article
- Metyrapone Treatment Protects Low-Density Lipoprotein Receptor Knockout Mice against Hypercorticosteronemia Development without Changing Atherosclerosis Susceptibility.Biomolecules · 2023Article
- Long-term efficacy and safety of osilodrostat in patients with Cushing's disease: results from the LINC 4 study extension.Frontiers in endocrinology · 2023Article
- Medical treatment of Cushing's disease with concurrent diabetes mellitus.Frontiers in endocrinology · 2023Review
- Review
- Long-term outcomes of osilodrostat in Cushing's disease: LINC 3 study extension.European journal of endocrinology · 2022Article
- Cushing's disease: adrenal steroidogenesis inhibitors.Pituitary · 2022Review
- Unmet needs in Cushing's syndrome: the patients' perspective.Endocrine connections · 2022Article
- The Role of Glucocorticoid Receptor in the Pathophysiology of Pituitary Corticotroph Adenomas.International journal of molecular sciences · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
INTRODUCTION AND
aimMedical treatment is increasingly used in patients with Cushing's syndrome (CS). Metyrapone (MET) is an inhibitor of 11β-hydroxylase: retrospective studies reported a decrease of cortisol secretion in 50% of cases. We evaluated the effectiveness of MET in an observational study, considering the normalization of urinary-free cortisol (UFC) and late-night salivary cortisol (LNSC) levels. MATERIALS AND
methodsWe enrolled 31 patients with CS, treated with MET for at least 1 month (16 for primary treatment and 15 after surgical failure). A planned dose-titration regimen considering baseline UFC levels was adopted; MET dose was uptitrated until UFC normalization, surgery, or side effect occurrence. UFC and LNSC levels were routinely measured by liquid chromatography-tandem mass spectrometry.
resultsPatients were treated with a median dose of 1000 mg for 9 months. UFC and LNSC decreased quickly after the first month of treatment (-67 and -57% from baseline), with sustained UFC normalization up to 12 and 24 months (in 13 and 6 patients, respectively). UFC and LNSC normalized later (after 3-6 months) in patients with severe hypercortisolism (>5-fold baseline UFC). Regarding the last visit, 70 and 37% of patients normalized UFC and LNSC, respectively. Body weight reduction (-4 kg) was observed after UFC normalization. Severe side effects were not reported, half of the female patients complained of hirsutism, and blood pressure was not increased.
conclusionsMET therapy is a rapid-onset, long-term effective, and safe medical treatment in CS patients, achieving UFC normalization (in 70% of patients) more than cortisol rhythm recovery (in 37% of subjects).
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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.