Endocrine Abstracts

Objective: Patients with Cushing syndrome (CS) have impaired health-related quality of life (HRQoL) before and after surgery. The data on the optimal hydrocortisone dose after surgical cure of CS is scarce. Therefore, we investigated the influence of hydrocortisone dose on HRQoL after surgical treatment of CS. We hypothesized that patients who receive higher hydrocortisone doses after surgery would have better HRQoL and fewer cortisol withdrawal symptoms.<p class="abstext"...

Background: When evaluating a patient for central adrenal insufficiency (CAI), there is a wide range of morning cortisol values for which no final conclusion on hypothalamus-pituitary-adrenal (HPA) axis function can be drawn; in these cases, a stimulation test is required. Aim of this study was to develop an integrated model for the prediction of CAI when morning cortisol is in the grey zone, here defined as 40.0-160.0 μg/l.Methods: Overall, 119 pat...

Background: The majority of adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are less than 10 mm in diameter and are described as microadenomas, while corticotroph macroadenomas (≥10 mm) are a less common cause of Cushing’s disease. Prior reports on the differences of clinical and biochemical behavior of corticotroph microadenomas and macroadenomas were inconsistent.Objective: Describe the clinical and biochemical characteristic...

Context: The long-term consequences of Covid-19 are unknown. Most patients experience persistent symptoms more than a month after the acute illness, including fatigue, dyspnea, memory loss, concentration disorder. The pituitary, the thyroid and the adrenal gland express the ACE-2 receptor, which is the cellular receptor for SARS-CoV-2, and could therefore be affected by the virus. However, the effect of Covid-19 on the hypothalamic-pituitary-adrenal-axis and hypothalamic-pitui...

Background: Improving physical manifestations of hypercortisolism is an important treatment goal for patients with Cushing’s disease (CD). In the Phase III LINC 3 study (NCT02180217), osilodrostat therapy, a potent oral 11β-hydroxylase inhibitor, rapidly normalised mean urinary free cortisol (mUFC) in most patients with CD and sustained control of mUFC over a median treatment period of 130 weeks (W). Here we describe concomitant improvements in physical manifestation...

Background: Osilodrostat (potent oral 11β-hydroxylase inhibitor) provided rapid normalisation of mean urinary free cortisol (mUFC) in Cushing’s disease (CD) patients during the 48-week (W) core period of LINC 4 (NCT02697734) and was well tolerated. We report long-term efficacy and safety results from the LINC 4 core and extension phases.Methods: 73 adults with CD and mUFC >1.3 upper limit of normal (ULN) were enrolled. LINC 4 comprised a 12...

Objective: Transsphenoidal surgery is the treatment of choice for Cushing’s disease (CD). Surgery is challenging due to the often very small adenomas. In experienced pituitary centers a high remission rate is reported. Nevertheless, endocrinologists and neurosurgeons face cases with persistent or recurrent CD. These patients must be referred to an experienced pituitary center. In addition to medical treatment, radiation therapy and bilateral adrenalectomy, repeat TSS must...