Evidence map›Paper›PMID 41423826›Full record

ArticleClinical endocrinology2026

Clinical Practice Patterns in Bone Health Assessment and Management in Endogenous Cushing's Syndrome.

Preeshila Behary, Dinushan Raveendran, Ramesh Nair, Aimee Di Marco, Debbie Papadopoulou, Florian Wernig, Ali Abbara, Karim Meeran, Niamh Martin, Jeremy Cox and 1 more

Abstract read
In one paragraph

Article in Clinical endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Preeshila BeharySection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Dinushan RaveendranSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Ramesh NairDepartment of Neurosurgery, Imperial College NHS Trust, London, UK.
Aimee Di MarcoDepartment of Endocrine Surgery, Imperial College NHS Trust, London, UK.ORCID https://orcid.org/0000-0002-0079-1194
Debbie PapadopoulouDepartment of Endocrinology, Imperial College NHS Trust, London, UK.
Florian WernigSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Ali AbbaraSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Karim MeeranSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Niamh MartinSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.
Jeremy CoxEndocrine Bone Unit, Imperial College NHS Trust, London, UK.
Alexander N ComninosSection of Endocrinology & Investigative Medicine, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSkeletal fragility is a common complication of endogenous Cushing's Syndrome (CS), although specific guidelines for managing bone health are lacking. This study aimed to assess clinicians' current engagement with bone health assessment and management in patients with endogenous CS.

designRetrospective-cohort design. PATIENTS: Seventy-nine patients with confirmed endogenous CS, treated at a tertiary endocrine centre. MEASUREMENTS: The frequency of bone health assessment, evidenced by vitamin D measurement, and bone health management, evidenced by a composite outcome of calcium and/or vitamin D optimisation and/or initiation of bone-protective agents, was recorded. Changes in bone mineral density (BMD), measured by Dual-energy X-ray absorptiometry (DEXA) and fracture prevalence were assessed pre- and post-CS treatment.

resultsVitamin D was measured in only 43% (34/79), and bone health was managed in only 39.2% (31/79). BMD was assessed in 44.3% (35/79) during active CS; of these, 22.9% had osteoporosis. Improved BMD was observed within a year of CS remission. Fractures occurred in 17.7% (14/79) within 2 years of CS diagnosis, and 12 additional fractures occurred during follow-up despite CS remission. Treatment with bone-protective agents expedited recovery with a significant increase in lumbar spine BMD, compared to those not treated.

conclusionsOur data demonstrate that skeletal impairment and fragility fractures are highly prevalent in endogenous CS, and fracture risk may persist despite remission. However, currently, bone health is inadequately assessed and managed. These findings identify an urgent need for improved awareness, assessment, and management of bone-health in this high-risk population and call for specific evidence-based practice guidelines.

Indexed as

Bone and BonesCushing SyndromePractice Patterns, Physicians'Absorptiometry, PhotonAdultAgedBone DensityFemaleFractures, BoneHumansMaleMiddle AgedOsteoporosisRetrospective StudiesVitamin DVitamin Dbone healthbone mineral density (BMD)calciumCushing's Syndromefragility fracturesosteoporosisvitamin D

Identifiers

PMID41423826
PMCPMC12954153

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Registered trials

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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.