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CS is associated with increased mortality and morbidity; therefore, a prompt diagnosis and an effective therapeutic approach are strongly necessary to improve the patient\u2019s clinical management. The first-line treatment for CS is surgery, while medical treatment has historically played a minor role. However, thanks to the availability of novel compounds, the possibility of improving hypercortisolism control using different drug combinations emerged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>No absolute recommendations are available to guide the therapeutic choice for patients with CS and, consequently, the awareness of unmet needs in CS management is growing. Although new data from clinical trials are needed to better define the most appropriate management of CS, an expert consensus approach can help define unmet needs and optimize the current CS management and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-seven endocrinologists from 12 Italian regions, working among the main Italian referral centers for hospital endocrinology where they take care of CS patients, were involved in a consensus process and used the Delphi method to reach an agreement on 24 statements about managing CS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 18 statements reached a consensus. Some relevant unmet needs in the management of CS were reported, mainly related to the lack of a pharmacological treatment successful for the majority of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While acknowledging the difficulty in achieving complete disease control, a significant change in CS management requires the availability of medical treatment with improved efficacy and safety over available therapeutic options at the time of the current study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40618-023-02058-8","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T13:02:34Z","timestamp":1681909354000},"page":"1923-1934","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Unmet needs on the current medical management of Cushing\u2019s syndrome: results from a Delphi panel of Italian endocrinologists"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-1348","authenticated-orcid":false,"given":"R.","family":"Pivonello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Scaroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Polistena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Migliore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Giustina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"issue":"1","key":"2058_CR1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s12020-016-0984-8","volume":"56","author":"R Pivonello","year":"2017","unstructured":"Pivonello R, De Martino MC, De Leo M, Simeoli C, Colao A (2017) Cushing\u2019s disease: the burden of illness. 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CS has been Principal Investigator of Clinical and\/or Translational Research Studies for Novartis, HRA Pharma, Shire, Cortendo AB-Strongbridge Biopharma, Pfizer, Recordati Rare Diseases; Co-investigator of Research Studies for Pfizer, Novartis; received research grants from Novartis, Pfizer, HRA Pharma; has been an occasional consultant for Novartis, Pfizer, Shire, HRA Pharma, Recordati Rare Diseases; and has received fees and honoraria for presentations from Novartis, Shire, Pfizer, Sandoz and Recordati Rare Diseases beyond the confines of this work. BP declares to have received in the last 5\u00a0years payments or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the following commercial sources: Allergan, Amgen, Astellas, Eli Lilly, Janssen Cilag, Nestle\u00b4 HS, Novartis, Novo Nordisk, Pfizer, Servier, Takeda, Teva; in addition, she received consulting fees from UCB. AG is consultant for Abiogen, Astellas, Ipsen, Novo. Pfizer, Recordati Rare Diseases, and Takeda and received research grants to the Institution from Ipsen, Novartis, Pfizer, Shire\/Takeda.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"It is not required as this manuscript does not include details, images or videos related to patients\/participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"The research does not involve human participants and\/or animals, their data or biological material.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}},{"value":"For this type of study formal consent is not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}