SynthesisFrontiers in endocrinology2021
Effectiveness of Medical Treatment of Cushing's Disease: A Systematic Review and Meta-Analysis.
Synthesis in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Outcomes of stereotactic radiosurgery in nelson's syndrome: a systematic review and Meta-Analysis.Pituitary · 2025Pooled it
- Ketoconazole as second-line treatment for Cushing's disease after transsphenoidal surgery: systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Pasireotide-Induced Shrinkage in GH and ACTH Secreting Pituitary Adenoma: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2022Pooled it
- Cushing's disease across the lifespan: a case-based clinical review.Archives of endocrinology and metabolism · 2026Review
- Clinical characteristics, diagnosis, and treatment of Cushing's syndrome: analysis of a multicenter registry in Antioquia, Colombia.Therapeutic advances in endocrinology and metabolism · 2026Article
- Individualized osilodrostat treatment for patients with ACTH-dependent Cushing's syndrome: real-world evidence.Frontiers in endocrinology · 2026Article
- Real-World Data on the Efficacy and Safety of Osilodrostat in Patients with Cushing's Disease in Spain.Journal of clinical medicine · 2025Article
- Safety management in Cushing syndrome during osilodrostat treatment based on morning blood cortisol level.Endocrine journal · 2025Article
- Review
- A Case of Spontaneously Resolving Cushing Disease.JCEM case reports · 2025Article
- Possible Clinical Effects of Ketoconazole on Sorafenib-induced Hand-Foot Skin Reaction and Cytoprotection Mechanisms of Antifungal Agents against Multikinase Inhibitor-induced Keratinocyte Toxicity.Acta dermato-venereologica · 2025Article
- Safety assessment of Osilodrostat: The adverse event analysis based on FAERS database by means of disproportionality analysis.PloS one · 2025Article
- Medical treatment of functional pituitary adenomas, trials and tribulations.Journal of neuro-oncology · 2024Review
- Budget impact analysis of cabergoline for medical treatment of Cushing's disease in Brazil.Archives of endocrinology and metabolism · 2024Article
- 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
- Evaluating the burden of endogenous Cushing's syndrome using a web-based questionnaire and validated patient-reported outcome measures.Pituitary · 2023Article
- Medical treatment of Cushing's disease with concurrent diabetes mellitus.Frontiers in endocrinology · 2023Review
- Osilodrostat-induced adrenal insufficiency in a patient with Cushing's disease.Clinical case reports · 2022Article
- Levoketoconazole.Hospital pharmacy · 2022Article
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 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The objective of this systematic review was to evaluate the effectiveness and safety of pasireotide, cabergoline, ketoconazole, levoketoconazole, metyrapone, osilodrostat, and temozolomide for the treatment of Cushing's disease (CD). Methods: The primary outcomes were the proportion of CD control, adverse events (AE), and reduction of urinary free cortisol. Search strategies were applied to Embase, Medline, and CENTRAL. Independent reviewers assessed the study eligibility, extracted data, and evaluated risk of bias. Standardized mean difference was calculated with 95% confidence interval (CI) for continuous data ( Results: Twenty-nine controlled and non-controlled studies were included. No study with temozolomide and levoketoconazole and one study with osilodrostat fulfilled the inclusion criteria. The meta-analyses of proportion of CD control was 35% for cabergoline (95% CI: 27-43%, six studies, 141 participants), 44% for pasireotide (95% CI: 25-35%, eight studies, 522 participants), 41% for ketoconazole (95% CI: 36-46%, six studies, 450 participants), 66% for metyrapone (95% CI: 46-87%, four studies, 66 participants), and of 66.4% for osilodrostat (95% CI: 57.9, 74.3, 97 participants, one study). One study compared two different treatments (cabergoline Conclusion: The superiority of one drug over another could not be determined due to lack of controlled studies, but the proportion of disease control identified in our meta-analysis may support clinical decision. New therapeutic options should be investigated due to the limited efficacy and tolerability of the currently available medical treatment for patients with Cushing's disease. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020205567, identifier CRD42020205567.
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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.