title: Therapy of endocrine disease: steroidogenesis enzyme inhibitors in Cushing's syndrome.
abstract: Steroidogenesis enzyme inhibitors are the mainstay of medical therapy in Cushing's syndrome (CS). Ketoconazole (KTZ) and metyrapone are the most commonly used agents. Although there is considerable experience of their use in individual specialist centres, these drugs have not been rigorously tested in prospective clinical trials. Clinicians face uncertainties and concerns with respect to the safety profile of these agents, and best means to monitor effect. We review steroidogenesis inhibitors in the management of CS, including older agents (KTZ, metyrapone, etomidate and mitotane) and those currently under development (LCI699, non-racemic KTZ), and offer a practical approach for their use in clinical practice.
authors: Department of Human MetabolismAcademic Unit of EndocrinologyDepartment of Endocrinology, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
authors: Eleni
authors: E
authors: Daniel
authors: Department of Human MetabolismAcademic Unit of EndocrinologyDepartment of Endocrinology, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK j.newellprice@sheffield.ac.uk.
authors: John D C
authors: JD
authors: Newell-Price
mesh_terms: D003480:Cushing Syndrome / Q000188:drug therapy*; D005045:Etomidate / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D007654:Ketoconazole / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D008797:Metyrapone / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D008939:Mitotane / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D065088:Steroid Synthesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology
chemical_list: D007093:Imidazoles; D011725:Pyridines; D065088:Steroid Synthesis Inhibitors; C553306:Osilodrostat; D008939:Mitotane; D007654:Ketoconazole; D005045:Etomidate; D008797:Metyrapone