ArticleEndocrine2025
Is there still a place for etomidate in the management of Cushing's syndrome? The experience of a single center of low-dose etomidate and combined etomidate-osilodrostat treatment in severe hypercortisolemia.
Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Ectopic ACTH-dependent Cushing syndrome in 3 hospitalized patients: lessons learned from management with osilodrostat.JCEM case reports · 2026Article
- Efficacy and safety of osilodrostat in patients with ectopic Cushing's syndrome.Hormones (Athens, Greece) · 2026Review
- Efficacy and safety of osilodrostat in patients with ectopic Cushing´s syndrome. a real-world study in Spain.Journal of endocrinological investigation · 2026Article
- From target specificity to metabolic efficiency: Design and optimization of etomidate analogues for potential improvement in postoperative outcomes.Acta pharmaceutica Sinica. B · 2026Article
- Normalization of Potassium Despite 11-Deoxycorticosterone Rise During Etomidate Therapy in Adrenocortical Carcinoma.JCEM case reports · 2026Article
- Alternating Therapy With Osilodrostat and Etomidate in Severe Ectopic Cushing's Syndrome Complicated by Silent Bowel Perforation.Case reports in endocrinology · 2026Article
- Management of cushing's syndrome in patients with adrenocortical cancer: state of the art and future perspectives.Reviews in endocrine & metabolic disorders · 2025Review
- Case Report: Ectopic Cushing's syndrome caused by a pancreatic neuroendocrine tumor managed through dual steroidogenesis inhibition and endoscopic ultrasound-guided ethanol ablation.Frontiers in endocrinology · 2025Article
- Successful Use of Continuous Etomidate Intravenous Infusion for Treatment of Ectopic Cushing Syndrome due to Small Cell Lung Carcinoma With Perforated Sigmoid Diverticulitis.AACE endocrinology and diabetesArticle
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6 authors.
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Abstract
purposeSevere Cushing's syndrome (SCS) is a life-threatening endocrine condition that requires prompt medical intervention. Intravenous etomidate infusion is considered to be the most effective in rapid cortisol overproduction inhibition. This single-center retrospective study aimed to present the safety and effectiveness of intravenous, low-dose, lipid-formulated etomidate infusion in patients with SCS.
methodsSeven patients with complicated SCS related to ectopic ACTH syndrome (n = 6) or Cushing's disease (n = 1) who received low-dose etomidate infusion as a part of their cortisol-lowering treatment between April 2019 and April 2024 in the Department of Internal Medicine, Endocrinology and Diabetes of Medical University of Warsaw were included in the study. A continuous etomidate infusion was initiated at 0.01-0.02 mg/kg/h.
resultsIn all patients, rapid control of hypercortisolemia was achieved with a median time of 30 h (range: 12-48 h). Median serum cortisol concentration reduced from 101.9 μg/dL (range: 78.2-119.6 μg/dL) before etomidate to 19.5 μg/dL (range: 18.3-22.5) after 72 h of etomidate treatment. Etomidate infusion was followed by etomidate and osilodrostat combined treatment and then osilodrostat monotherapy in four patients; one patient underwent adrenalectomy, and two patients died during etomidate infusion due to complications of advanced malignancy.
conclusionsThis study shows that low-dose and short-term lipid formulation etomidate therapy is highly effective in severe hypercortisolemia management. Combined therapy with etomidate and osilodrostat is well tolerated and could serve as a bridge in long-term SCS treatment.
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