{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:46:31Z","timestamp":1791909991242,"version":"4.3.4"},"reference-count":33,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Steroidogenesis inhibitors can be given to control the hypercortisolism of Cushing\u2019s syndrome in various situations: when surgery has been unsuccessful or not possible; in metastatic adrenocorticotropin hormone (ACTH) or cortisol-secreting tumors; when waiting for the maximal efficacy of radiation techniques; for rapid treatment of severe hypercortisolism in patients with occult ACTH-producing tumors; or as a presurgical treatment in patients with severe comorbidities. Whilst biochemical \u201ccontrol\u201d can be achieved in more than 50% of cases, daily management of such drugs can be challenging. Indeed, with a \u201cdose-titration\u201d or a \u201cblock and replace\u201d approach, defining eucortisolism is usually difficult, requiring the measurement of several biological markers. Moreover, each drug has its own side effects, which must be monitored closely. The aim of this \u201capproach to the patient\u201d is to shed light on the management of hypercortisolism with 4 steroidogenesis inhibitors (ketoconazole, levoketoconazole, metyrapone, osilodrostat) to help endocrinologists dealing with patients with Cushing\u2019s syndrome. Various points will be discussed, such as initial dose of treatment, dose schedule, monitoring of efficacy, and side effects of monotherapy. The combination of steroidogenesis inhibitors will also be discussed.<\/jats:p>","DOI":"10.1210\/clinem\/dgab122","type":"journal-article","created":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T15:39:21Z","timestamp":1615045161000},"page":"2114-2123","source":"Crossref","is-referenced-by-count":76,"title":["Approach to the Patient Treated with Steroidogenesis Inhibitors"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-8800","authenticated-orcid":false,"given":"Frederic","family":"Castinetti","sequence":"first","affiliation":[{"name":"Aix Marseille University, Marseille Medical Genetics, INSERM U1251 and Assistance Publique Hopitaux de Marseille, La Conception Hospital, Department of Endocrinology, Marseille 13005, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynnette K","family":"Nieman","sequence":"additional","affiliation":[{"name":"Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes 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