The Medical Treatment of Cushing’s Disease: Effectiveness of Chronic Treatment with the Dopamine Agonist Cabergoline in Patients Unsuccessfully Treated by Surgery

Abstract

The results of this study demonstrated that cabergoline treatment is effective in controlling cortisol secretion for at least 1-2 yr in more than one third of a limited population of patients with CD. If this evidence is confirmed by additional studies, this agent may be considered as a useful treatment option in patients with CD who are unsuccessfully treated by neurosurgery.

Association Between Mifepristone Dose, Efficacy, and Tolerability in Patients With Cushing Syndrome

“…Medical treatment may also be used in preparation for surgery or when surgery is not feasible, as adjunctive treatment in patients who have failed surgery, or as a bridge for radiotherapy until remission of hypercortisolism occurs (7,13,14). Such medical treatments, including ketoconazole, cabergoline, metyrapone, and mitotane, have been widely used in clinical practice (15)(16)(17)(18)(19)(20)(21), but none of these are licensed for use to treat patients with endogenous CS. Centrally acting agents that target excessive pituitary adrenocorticotropic hormone (ACTH) secretion, inhibitors of See accompanying article, p. 1175. steroidogenesis, or glucocorticoid receptor antagonists have been utilized depending on the underlying cause of CS.…”

Budget impact of pasireotide for the treatment of Cushing’s disease, a rare endocrine disorder associated with considerable comorbidities

“…Reimbursement values for each CPT code (50th percentile) for physician services or outpatient services/procedures/labs were obtained from the MAG Mutual Physicians' Fee and Coding Guide 2012, and were summed separately to generate costs of surgery or radiation therapy. Costs for drug therapies in both scenarios are calculated based on the mean recommended daily dosage for each treatment (obtained from published literature) 2,28,[36][37][38] . Daily drug costs are estimated by multiplying mean daily dose (in mg) with the lowest drug cost per mg that was obtained using the wholesale acquisition cost (WAC) from the 2013 Drug Topics Redbook 39 .…”

“…A literature review was conducted and eight studies identified as the most appropriate clinical studies for inclusion in the total budget impact model 37,38,[40][41][42][43][44][45] . Fourteen unique AEs were identified, of which hypopituitarism was associated with TSS, RS, and RT.…”

Análise da expressão da filamina A nos tumores hipofisários e suas implicações clínicas e terapêuticas

“…Quanto ao grupo de corticotropinomas, a taxa de resposta hormonal com CAB e a expressão de DRD2 moderada ou intensa também foram compatíveis com os dados de literatura (124)(125)(126)(127)(128)(129)(130) . Em nosso estudo, não encontramos correlação entre expressão de DRD2 e resposta hormonal à CAB, o que foi descrito em apenas um estudo, ainda que sem significância estatística (125) .…”

“…Há sete séries de casos de pacientes com Doença de Cushing, sem remissão após o tratamento cirúrgico, submetidos ao tratamento com CAB (124)(125)(126)(127)(128)(129)(130) . (128) .…”