ArticleFrontiers in endocrinology2025
Real-life data on pasireotide in monotherapy or combined in active Cushing's disease.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: In the last few years, the use of medical treatment in Cushing's disease (CD) has increased thanks to the availability of new molecules. Nevertheless, real-life data on combination treatments are still lacking. Methods: This is a retrospective monocentric study evaluating the real-life efficacy and safety of pasireotide alone or when combined with cabergoline or metyrapone. Results: A total of 18 patients (94% women; median age, 45 years) with active CD received pasireotide (median, 8 months), followed by a combination treatment (median, 22 months) with either cabergoline (2/9) or metyrapone (7/9) for half of the patients. Pasireotide alone significantly reduced urinary free cortisol (UFC) and late-night salivary cortisol (LNSC) ( Discussion: Our experience confirms the efficacy of pasireotide on the UFC, especially in combined regimens, but also the difficulty of restoring circadian rhythm in CD. This is the first study to report metyrapone add-on to pasireotide, but larger studies are needed to further investigate this association. Pasireotide surely worsens glucose homeostasis, but its positive effects, alone or combined, on blood pressure, lipid profile, and body weight justify its use under careful hyperglycemia management.
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