ArticleThe Journal of clinical endocrinology and metabolism2021
Approach to the Patient Treated with Steroidogenesis Inhibitors.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 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
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 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
- Levoketoconazole treatment in endogenous Cushing's syndrome: extended evaluation of clinical, biochemical, and radiologic outcomes.European journal of endocrinology · 2022Trial
- Long-term cyclic ectopic adrenocorticotropic hormone syndrome with extreme fluctuations and adrenal insufficiency.JCEM case reports · 2026Article
- Ectopic ACTH-Secreting Pituitary Adenoma of the Maxillary Sinus: A Rare Cause of Cushing's Syndrome.Turkish archives of otorhinolaryngology · 2026Article
- Efficacy and safety of osilodrostat in patients with ectopic Cushing's syndrome.Hormones (Athens, Greece) · 2026Review
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Real-World Osilodrostat Effectiveness and Safety in Nonpituitary Cushing Syndrome.The Journal of clinical endocrinology and metabolism · 2026Observational
- Soothing a Ruffled Mind: Chronotherapy of Cushing Syndrome.The Journal of clinical endocrinology and metabolism · 2026Article
- Use of osilodrostat in a block-and-replace and titration strategy for cushing's syndrome: a position paper by French experts.Reviews in endocrine & metabolic disorders · 2026Article
- European Society of Neuroendocrine Tumors (ENETS) 2025 guidance paper for lung and thymic carcinoids.Journal of neuroendocrinology · 2026Article
- Use of PRRT and osilodrostat for ectopic Cushing syndrome secondary to thymic neuroendocrine neoplasm.Endocrinology, diabetes & metabolism case reports · 2026Article
- Postoperative adrenal crisis and atrial tachycardia associated with an ectopic ACTH-secreting thymic neuroendocrine tumor: a case report and literature review.BMC endocrine disorders · 2026Review
- Management of cushing's syndrome in patients with adrenocortical cancer: state of the art and future perspectives.Reviews in endocrine & metabolic disorders · 2025Review
- Safety management in Cushing syndrome during osilodrostat treatment based on morning blood cortisol level.Endocrine journal · 2025Article
- Review
- Management of Osilodrostat Therapy in Patients With Cushing's Syndrome: A Modified Delphi Consensus Panel.Journal of the Endocrine Society · 2025Article
- Management of Cushing's disease in the initial phase~From detection to surgery~.Endocrine journal · 2025Review
- Spanish consensus on the diagnosis and management of adrenocortical carcinoma.Endocrine-related cancer · 2025Review
- Successful Treatment of Severe Ectopic ACTH-Dependent Cushing Syndrome Complicated by Hypocalcemia With Osilodrostat.JCEM case reports · 2025Article
- Medical Treatment of Cushing's Syndrome.Endocrinology and metabolism (Seoul, Korea) · 2025Review
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 4 countries.
Funding
Abstract
Steroidogenesis inhibitors can be given to control the hypercortisolism of Cushing's syndrome in various situations: when surgery has been unsuccessful or not possible; in metastatic adrenocorticotropin hormone (ACTH) or cortisol-secreting tumors; when waiting for the maximal efficacy of radiation techniques; for rapid treatment of severe hypercortisolism in patients with occult ACTH-producing tumors; or as a presurgical treatment in patients with severe comorbidities. Whilst biochemical "control" can be achieved in more than 50% of cases, daily management of such drugs can be challenging. Indeed, with a "dose-titration" or a "block and replace" approach, defining eucortisolism is usually difficult, requiring the measurement of several biological markers. Moreover, each drug has its own side effects, which must be monitored closely. The aim of this "approach to the patient" is to shed light on the management of hypercortisolism with 4 steroidogenesis inhibitors (ketoconazole, levoketoconazole, metyrapone, osilodrostat) to help endocrinologists dealing with patients with Cushing's syndrome. Various points will be discussed, such as initial dose of treatment, dose schedule, monitoring of efficacy, and side effects of monotherapy. The combination of steroidogenesis inhibitors will also be discussed.
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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.