Endocrine Abstracts

Surgery remains the first line treatment of Cushing’s disease. However, recent studies based on long term follow-up showed that the risk of late recurrence was close to 20–30% cases, whatever the immediate post-surgical cortisol level. In other cases, surgery is not possible due to contra-indications, or refusal by the patient. Medical treatment is thus of major importance in the management of Cushing’s disease, also taking into account the delay to obtain maximal efficacy of radiation techniques, when they are indicated.

This talk will be aimed at showing the main merits and pitfalls of anticortisolic drugs, first by evaluating the recently used new pituitary targeted drugs, and then by comparing them to the classical adrenal targeted anticortisolic drugs. Among these, ketoconazole should be considered as a valuable treatment. Despite a relatively low number of cases reported to date, this drug has been shown to be effective and relatively safe. We will present here the results of a French multicentric retrospective study based on more than 150 patients treated by ketoconazole for Cushing’s disease, and will try to define its role in the therapeutic algorithm of this disease.