{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:02:13Z","timestamp":1772578933793,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,17]],"date-time":"2013-10-17T00:00:00Z","timestamp":1381968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>Mifepristone, a glucocorticoid receptor antagonist, improves clinical status in patients with Cushing's syndrome (CS<\/jats:styled-content>). We examined the pattern, reliability and correlates of global clinical response (GCR<\/jats:styled-content>) assessments during a 6\u2010month clinical trial of mifepristone in CS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Design<\/jats:title>Post hoc<\/jats:italic> analysis of secondary end\u2010point data from a 24\u2010week multicentre, open\u2010label trial of mifepristone (300\u20131200\u00a0mg daily) in CS<\/jats:styled-content>. Intraclass correlation coefficient (ICC<\/jats:styled-content>) was used to examine rater concordance, and drivers of clinical improvement were determined by multivariate regression analysis.<\/jats:p><\/jats:sec>Patients<\/jats:title>Forty\u2010six adult patients with refractory CS<\/jats:styled-content> along with diabetes mellitus type 2 or impaired glucose tolerance, and\/or a diagnosis of hypertension.<\/jats:p><\/jats:sec>Measurements<\/jats:title>Global clinical assessment made by three independent reviewers using a three\u2010point ordinal scale (+1 = improvement; 0\u00a0=\u00a0no change; \u22121\u00a0=\u00a0worsening) based on eight broad clinical categories including glucose control, lipids, blood pressure, body composition, clinical appearance, strength, psychiatric\/cognitive symptoms and quality of life at Weeks 6, 10, 16, and 24.<\/jats:p><\/jats:sec>Results<\/jats:title>Positive GCR<\/jats:styled-content> increased progressively over time with 88% of patients having improved at Week 24 (P<\/jats:italic>\u00a0<\u00a00\u00b7001). The full concordance among reviewers occurred in 76\u00b76% of evaluations resulting in an ICC<\/jats:styled-content> of 0\u00b7652 (P<\/jats:styled-content><\/jats:italic>\u00a0<\u00a00\u00b7001). Changes in body weight (P<\/jats:styled-content><\/jats:italic>\u00a0<\u00a00\u00b70001), diastolic blood pressure (P<\/jats:styled-content><\/jats:italic>\u00a0<\u00a00\u00b70001), two\u2010hour postoral glucose challenge glucose concentration (P<\/jats:italic> = 0\u00b70003), and C<\/jats:styled-content>ushingoid appearance (P<\/jats:styled-content><\/jats:italic>\u00a0=\u00a00\u00b7022) were strong correlates of GCR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Mifepristone treatment for CS<\/jats:styled-content> results in progressive clinical improvement. Overall agreement among clinical reviewers was substantial and determinants of positive GCR<\/jats:styled-content> included change in weight, blood pressure, glucose levels and appearance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12332","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T15:51:34Z","timestamp":1381247494000},"page":"562-569","source":"Crossref","is-referenced-by-count":40,"title":["Global clinical response in C<\/scp>ushing's syndrome patients treated with mifepristone"],"prefix":"10.1111","volume":"80","author":[{"given":"Laurence","family":"Katznelson","sequence":"first","affiliation":[{"name":"Medicine and Neurosurgery Stanford University Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Lynn","family":"Loriaux","sequence":"additional","affiliation":[{"name":"Medicine Oregon Health Science University Portland OR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Feldman","sequence":"additional","affiliation":[{"name":"Medicine and Neurosurgery Stanford University Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn D.","family":"Braunstein","sequence":"additional","affiliation":[{"name":"Medicine Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E.","family":"Schteingart","sequence":"additional","affiliation":[{"name":"Medicine University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Coleman","family":"Gross","sequence":"additional","affiliation":[{"name":"Corcept Therapeutics Menlo Park CA 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