New options in the treatment of Cushing's disease: a focus on pasireotide

Poullot, Anne-Gaƫlle; Chevalier, Nicolas
May 2013
Research & Reports in Endocrine Disorders;May2013, Vol. 3, p31
Academic Journal
Cushing's disease is caused by a corticotroph pituitary adenoma secreting adreno-corticotropin and can be fatal in the absence of adequate treatment. Transsphenoidal surgery remains the treatment of choice in almost all cases. However, remission rates are relatively low, and recurrence is usual and can be diagnosed up to decades after the initial diagnosis. Repeat surgery or radiation can be useful in these cases, although both have clear limitations with respect to efficacy and/or side effects. Hence, there is a clear unmet need for an effective medical treatment in patients with recurrent or persistent Cushing's disease. Pasireotide is a novel multireceptor-targeted somatostatin analog with a high affinity for somatostatin receptor (sstr)-1, sstr-2, sstr-3, and sstr-5. Compared with octreotide, pasireotide has an in vitro binding affinity 40-fold higher for sstr-5, which is the major receptor subtype expressed by corticotroph pituitary adenoma. Recent studies have suggested a role for this new multireceptor somatostatin analog in Cushing's disease. We review in this article the current data available regarding pharmacokinetics, clinical efficiency, and tolerance of pasireotide in patients with de novo, persistent, or recurrent Cushing's disease, with a special focus on the disturbances of glucose metabolism induced by such a treatment.


Related Articles

  • Cushing's Syndrome. Orth, David N. // New England Journal of Medicine;3/23/95, Vol. 332 Issue 12, p791 

    States that the understanding of the pathophysiologic features of Cushing's syndrome, and the ability to diagnose and treat the disorder, has improved. Difference between Cushing's syndrome and Cushing's disease; Ectopic corticotropin syndrome; Discussion of small-cell lung carcinoma and acute...

  • Cushing's Disease: Clinical Manifestations and Diagnostic Evaluation.  // American Family Physician;9/1/2000, Vol. 62 Issue 5, p1119 

    The most common endogenous cause of Cushing's syndrome is Cushing's disease. Frequent clinical findings include weight gain, truncal obesity, striae, hypertension, glucose intolerance and infections.Cranial nerve II may be affected by enlarging pituitary adenomas in Cushing's disease; cranial...

  • Triamcinolone overdose.  // Reactions Weekly;2/8/2014, Issue 1487, p34 

    The article presents a case study of a 33-year-old man diagnosed with Cushing syndrome while receiving triamcinolone for wrist tenosynovitis.

  • NEW PRODUCTS: RAYOS.  // Monthly Prescribing Reference;Apr2013, Vol. 29 Issue 4, pA-13 

    The article provides information on Rayos, a glucocorticoid for corticosteroid-responsive disorders, from Horizon Pharma. It identifies the pharmacology of Rayos and presents the results of clinical trials on the efficacy of Rayos in the treatment of rheumatoid arthritis. Its shows the drug's...

  • Fluconazole/fluticasone propionate interaction.  // Reactions Weekly;9/24/2011, Issue 1370, p20 

    The article describes the case of a 9-year-old girl who developed adrenal insufficiency and Cushing syndrome while receiving concomitant treatment with fluticasone propionate and fluconazole.

  • Pharmaco-prosthodontics revisited. Jagadeeshwaran, A. R.; Arora, Dhruv; Arun Kumar, V. R.; Raj Kumar, G.; Balamurugan, T.; Prabu, P. S. // Journal of Pharmacy & Bioallied Sciences;Aug2012 Supplement, pS338 

    Pharmacology is the branch of medicine and biology concerned with the study of drug action. The two main aspects of concern are the effects of drugs on biological systems and the effect of biological systems on efficacy and metabolism of drugs. Prosthodontics is that specialty of dentistry which...

  • Medical Mystery Answer: Male Infant with Unusual Weight Gain and Rash. Baden, Lindsey R. // New England Journal of Medicine;3/10/2005, Vol. 352 Issue 10, p1047 

    The article presents information on a study related to the diagnosis of Cushing's disease. For the study 1188 responses were submitted from 72 countries. Abnormalities consistent with Cushing's syndrome was suggested by sixty-seven percent of the respondents. Out of these sixty-seven percent...

  • The difficulties of Cushing's syndrome.  // Endocrine Today;11/25/2008, Vol. 6 Issue 21, p1 

    The article focuses on the challenges posed by the diagnosis and treatment of Cushing's syndrome to endocrinologists. A clinical review by Hershel Raff and James W. Findling reportedly indicates the need for an accurate diagnostic test for the disease as the number of patients is increasing....

  • Spot urine cortisol-creatinine ratio - A useful screening test in the diagnosis of Cushing's syndrome. Kapoor, Nitin; Job, Victoria; Jayaseelan, L.; Rajaratnam, Simon // Indian Journal of Endocrinology & Metabolism;Dec2012 Supplement, Vol. 16, pS376 

    Introduction: Although, there are several tests available, not one of them fulfils the criteria of being an ideal screening test. Continuing the search for an ideal screening test, we explored the use of urine spot cortisol-creatinine ratio as a novel method of evaluating patients with Cushing's...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics