{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T14:30:01Z","timestamp":1771943401057,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,14]],"date-time":"2018-08-14T00:00:00Z","timestamp":1534204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011323","name":"African Fellowship Trust","doi-asserted-by":"publisher","award":["1K08DK109116"],"award-info":[{"award-number":["1K08DK109116"]}],"id":[{"id":"10.13039\/100011323","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Mifepristone, a glucocorticoid receptor antagonist, can be used to manage hypercortisolism in patients with ectopic adrenocorticotropic hormone syndrome (<jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content>) when surgical cure is not feasible. Outcomes of <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content> patients treated with mifepristone have been limited to reports of isolated cases. We aimed to determine the efficacy and limitations of mifepristone in the treatment of <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content> and to compare outcomes with those of patients who underwent bilateral adrenalectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study of <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content> patients from the University of Michigan between 1997 and 2017 was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 55 patients with <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content>, 16 were treated with mifepristone: eight neuroendocrine tumours, two carcinomas and six occult tumours. Treatment with mifepristone was most commonly prompted by psychosis, uncontrolled glucose and\/or hypertension. The median maintenance dose was 600\u00a0mg\/d. Amelioration of psychosis was observed within 48\u00a0hours in 3\/3 patients, and the glycaemic control was improved in 14\/16 patients. The median duration of treatment was 9\u00a0months, and three patients were treated for more than 24\u00a0months. The overall survival at 24\u00a0months was equivalent between patients with <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content> treated with mifepristone vs bilateral adrenalectomy (N\u00a0=\u00a012) (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mifepristone is effective in treating <jats:styled-content style=\"fixed-case\">EAS<\/jats:styled-content> for over 2\u00a0years, and survival was not different from that of patients treated with bilateral adrenalectomy. Aggressive concomitant therapy for hypokalaemia and hypertension is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13818","type":"journal-article","created":{"date-parts":[[2018,7,18]],"date-time":"2018-07-18T18:46:45Z","timestamp":1531939605000},"page":"570-576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Mifepristone in the treatment of the ectopic adrenocorticotropic hormone syndrome"],"prefix":"10.1111","volume":"89","author":[{"given":"Taweesak","family":"Wannachalee","sequence":"first","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes University of Michigan  Ann Arbor Michigan"},{"name":"Division of Endocrinology and Metabolism Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina F.","family":"Turcu","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes University of Michigan  Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6815-6181","authenticated-orcid":false,"given":"Richard J.","family":"Auchus","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes University of Michigan  Ann Arbor Michigan"},{"name":"Department of Pharmacology University of Michigan  Ann Arbor 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