{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:22:02Z","timestamp":1788499322528,"version":"build-2803163510"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Severe Cushing\u2019s syndrome (SCS) is a life-threatening endocrine condition that requires prompt medical intervention. Intravenous etomidate infusion is considered to be the most effective in rapid cortisol overproduction inhibition. This single-center retrospective study aimed to present the safety and effectiveness of intravenous, low-dose, lipid-formulated etomidate infusion in patients with SCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven patients with complicated SCS related to ectopic ACTH syndrome (n\u2009=\u20096) or Cushing\u2019s disease (n\u2009=\u20091) who received low-dose etomidate infusion as a part of their cortisol-lowering treatment between April 2019 and April 2024 in the Department of Internal Medicine, Endocrinology and Diabetes of Medical University of Warsaw were included in the study. A continuous etomidate infusion was initiated at 0.01\u20130.02\u2009mg\/kg\/h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all patients, rapid control of hypercortisolemia was achieved with a median time of 30\u2009h (range: 12\u201348\u2009h). Median serum cortisol concentration reduced from 101.9\u2009\u03bcg\/dL (range: 78.2\u2013119.6\u2009\u03bcg\/dL) before etomidate to 19.5\u2009\u03bcg\/dL (range: 18.3\u201322.5) after 72\u2009h of etomidate treatment. Etomidate infusion was followed by etomidate and osilodrostat combined treatment and then osilodrostat monotherapy in four patients; one patient underwent adrenalectomy, and two patients died during etomidate infusion due to complications of advanced malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows that low-dose and short-term lipid formulation etomidate therapy is highly effective in severe hypercortisolemia management. Combined therapy with etomidate and osilodrostat is well tolerated and could serve as a bridge in long-term SCS treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-024-04135-1","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T16:49:10Z","timestamp":1734540550000},"page":"1305-1313","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Is there still a place for etomidate in the management of Cushing\u2019s syndrome? The experience of a single center of low-dose etomidate and combined etomidate-osilodrostat treatment in severe hypercortisolemia"],"prefix":"10.1007","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9283-4827","authenticated-orcid":false,"given":"Lukasz","family":"Dzialach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0440-2851","authenticated-orcid":false,"given":"Joanna","family":"Sobolewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wioleta","family":"Respondek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1520-7752","authenticated-orcid":false,"given":"Agnieszka","family":"Wojciechowska-Luzniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2224-5554","authenticated-orcid":false,"given":"Pawel","family":"Kuca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4512-4624","authenticated-orcid":false,"given":"Przemys\u0142aw","family":"Witek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"4135_CR1","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1001\/jama.2023.11305","volume":"330","author":"M Reincke","year":"2023","unstructured":"M. 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Author J.S., W.R., A.W-L., and P.K. declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Ethics Committee of Medical University of Warsaw (permission number: AKBE\/170\/2024) and was performed in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As this was a retrospective study on medical files and all the procedures being performed were part of the routine care, patient\u2019s informed consent in the opinion of the local bioethics committee was not required. However, before etomidate infusion and after obtaining comprehensive information (including off-label use of etomidate), each patient signed informed consent for etomidate treatment and for the use of data obtained during treatment for scientific purposes, which is included in the patient\u2019s medical history.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}