ArticlePituitary2025
Medical management pathways for Cushing's disease in pituitary tumors centers of excellence (PTCOEs).
Article in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07603466 (Combination Osilodrostat and Cabergoline Versus Osilodrostat Alone in Cushing's Disease in Iraq), which is not on this map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Combination Osilodrostat and Cabergoline Versus Osilodrostat Alone in Cushing's Disease in Iraq: Assessment of Efficacy and Safety
Who cites it
8 citing papers in PubMed.
- Protracted osilodrostat-induced pan-adrenal steroidogenic suppression and adrenal size reduction in Cushing disease.JCEM case reports · 2026Article
- Patient-reported outcomes in a Pituitary Tumor Center of Excellence (PTCOE)-aligned pituitary clinic compared with general endocrinology care.Pituitary · 2026Article
- Individualized osilodrostat treatment for patients with ACTH-dependent Cushing's syndrome: real-world evidence.Frontiers in endocrinology · 2026Article
- Controlling cortisol excess and comorbidities in Cushing's syndrome with osilodrostat.Pituitary · 2025Article
- The feedback loop in pituitary surgery.Pituitary · 2025Article
- Evaluating pituitary tumor management: aligning with pituitary tumor centers of excellence criteria.Pituitary · 2025Article
- Impulse control disorders in pituitary adenoma: What do we know and what we still don't know in almost two decades?Pituitary · 2025Article
- Management of patients with Cushing's disease in the Gulf Region: a Delphi consensus recommendation.Frontiers in endocrinology · 2025Article
Corrections and comments
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA recent update of consensus guidelines for the management of Cushing's disease (CD) included indications for medical therapy. However, there is limited evidence regarding their implementation in clinical practice. This study aimed to evaluate current medical therapy approaches by expert pituitary centers through an audit conducted to validate the criteria of Pituitary Tumors Centers of Excellence (PTCOEs) and provide an initial standard of medical care for CD.
methodsBased on the activities of nine international PTCOEs between 2018 and 2020, we evaluated patients under medical treatment and their biochemical control rates.
resultsThe median number of active patients with CD per center was 117 (35-279), with a median number of 10 new patients with CD managed annually in the endocrinology units of PTCOEs (4-42). The median percentage of patients with CD receiving medical treatment was 13.3% (4.8-82.9). Ketoconazole was the most frequently used drug, with a median rate of usage of 26.5% (5-66.7) of those receiving medical therapy. The median rates of metyrapone and pasireotide use were 17.2% (0-50) and 9.3% (0-51.7), respectively. For cabergoline and osilodrostat, therapy, the median rates of use were 2.8% (0-33.3), and 1.7% (0-25), respectively. Combination therapy was reported to be utilized in 13.6% (0-45.5) of medically treated patients. Mifepristone was used in a single center, representing 1.1% of its medically treated patients. Overall, the median control rate in patients with CD receiving medical treatment was 75% (10-100).
conclusionAdrenal steroidogenesis inhibitors were the most commonly used medications amongst the centers. Despite the use of combination therapy, up to 25% of patients did not achieve disease control even in PTCOEs, highlighting the need for either more efficient combination therapies or novel therapeutic options.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.