Biochemical control during long-term follow-up of 230 adult patients with Cushing disease: A multicenter retrospective study Journal Article
| Authors: | Geer, E. B.; Shafiq, I.; Gordon, M. B.; Bonert, V.; Ayala, A.; Swerdloff, R. S.; Katznelson, L.; Lalazar, Y.; Manuylova, E.; Pulaski-Liebert, K. J.; Carmichael, J. D.; Hannoush, Z.; Surampudi, V.; Broder, M. S.; Cherepanov, D.; Eagan, M.; Lee, J.; Said, Q.; Neary, M. P.; Biller, B. M. K. |
| Article Title: | Biochemical control during long-term follow-up of 230 adult patients with Cushing disease: A multicenter retrospective study |
| Abstract: | Objective: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Methods: Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Results: Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Conclusion: Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-Term control is not achieved in a substantial number of patients with CD. Copyright © 2017 AACE. |
| Keywords: | adolescent; adult; controlled study; treatment outcome; aged; middle aged; retrospective studies; young adult; major clinical study; clinical trial; mortality; hypertension; antineoplastic agents; follow up; neurosurgery; follow-up studies; antineoplastic agent; clinical practice; metabolism; tumor volume; radiotherapy; prevalence; obesity; dexamethasone; pathology; enzyme inhibitor; retrospective study; insomnia; adenoma; tumor burden; enzyme inhibitors; multicenter study; comorbidity; muscle weakness; mental disease; antidiabetic agent; skin disease; ketoconazole; mifepristone; hormone; urogenital tract disease; neurologic disease; rosiglitazone; hyperlipidemia; musculoskeletal disease; somatostatin; hyperlipidemias; hormones; neurosurgical procedures; descriptive research; weight gain; complication; hirsutism; ovary polycystic disease; hormone antagonist; bromocriptine; adrenalectomy; hormone antagonists; pituitary irradiation; pasireotide; pioglitazone; thiazolidinediones; polydipsia; 2,4 thiazolidinedione derivative; hypoglycemic agents; cushing disease; humans; human; male; female; article; muscular atrophy; analogs and derivatives; cabergoline; metyrapone; ergoline derivative; sterol 14alpha demethylase inhibitor; acth-secreting pituitary adenoma; obesity, abdominal; pituitary acth hypersecretion; polycystic ovary syndrome; striae distensae; 14-alpha demethylase inhibitors; ergolines |
| Journal Title: | Endocrine Practice |
| Volume: | 23 |
| Issue: | 8 |
| ISSN: | 1530-891X |
| Publisher: | American Association of Clinical Endocrinologists |
| Date Published: | 2017-08-01 |
| Start Page: | 962 |
| End Page: | 970 |
| Language: | English |
| DOI: | 10.4158/ep171787.or |
| PUBMED: | 28614003 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 December 2017 -- Source: Scopus |
