{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:59:05Z","timestamp":1791136745267,"version":"4.1.0"},"reference-count":119,"publisher":"Bioscientifica","issue":"6","content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"Abstract<\/jats:title>\n Cushing's syndrome (CS) is a severe endocrine disorder characterized by chronic cortisol excess due to an ACTH-secreting pituitary adenoma, ectopic ACTH production, or a cortisol-producing adrenal neoplasia. Regardless of the underlying cause, untreated CS is associated with considerable morbidity and mortality. Surgery is the primary therapy for all causes of CS, but surgical failure and ineligibility of the patient to undergo surgery necessitate alternative treatment modalities. The role of medical therapy in CS has been limited because of lack of efficacy or intolerability. In recent years, however, new targets for medical therapy have been identified, both at the level of the pituitary gland (e.g. somatostatin, dopamine, and epidermal growth factor receptors) and the adrenal gland (ectopically expressed receptors in ACTH-independent macronodular adrenal hyperplasia). In this review, results of preclinical and clinical studies with drugs that exert their action through these molecular targets, as well as already established medical treatment options, will be discussed.<\/jats:p>","DOI":"10.1530\/erc-12-0191","type":"journal-article","created":{"date-parts":[[2012,8,31]],"date-time":"2012-08-31T00:55:26Z","timestamp":1346374526000},"page":"R205-R223","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":36,"title":["New developments in the medical treatment of Cushing's syndrome"],"prefix":"10.1530","volume":"19","author":[{"given":"R","family":"van der Pas","sequence":"first","affiliation":[{"name":"Division of Endocrinology","department":["Department of Internal Medicine, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W W","family":"de Herder","sequence":"additional","affiliation":[{"name":"Division of Endocrinology","department":["Department of Internal Medicine, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L J","family":"Hofland","sequence":"additional","affiliation":[{"name":"Division of Endocrinology","department":["Department of Internal Medicine, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"Feelders","sequence":"additional","affiliation":[{"name":"Division of Endocrinology","department":["Department of Internal Medicine, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"2026070909381008400_bib1","doi-asserted-by":"crossref","unstructured":"Allolio\n B\n \n \n Stuttmann\n R\n \n \n Fischer\n H\n \n \n Leonhard\n W\n \n \n Winkelmann\n W\n \n \n 1983\n Long-term etomidate and adrenocortical suppression. 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Clinical Neuropathology28430\u2013439."},{"key":"2026070909381008400_bib54","doi-asserted-by":"crossref","unstructured":"Lacroix\n A\n \n \n 2009\n ACTH-independent macronodular adrenal hyperplasia. Best Practice & Research. Clinical Endocrinology & Metabolism23245\u2013259. (doi:10.1016\/j.beem.2008.10.011).","DOI":"10.1016\/j.beem.2008.10.011"},{"key":"2026070909381008400_bib55","doi-asserted-by":"crossref","unstructured":"Lacroix\n A\n \n \n Tremblay\n J\n \n \n Rousseau\n G\n \n \n Bouvier\n M\n \n \n Hamet\n P\n \n \n 1997\n Propranolol therapy for ectopic \u03b2-adrenergic receptors in adrenal Cushing's syndrome. New England Journal of Medicine3371429\u20131434. (doi:10.1056\/NEJM199711133372004).","DOI":"10.1056\/NEJM199711133372004"},{"key":"2026070909381008400_bib56","doi-asserted-by":"crossref","unstructured":"Lacroix\n A\n \n \n Hamet\n P\n \n \n Boutin\n JM\n \n \n 1999\n Leuprolide acetate therapy in luteinizing hormone \u2013 dependent Cushing's syndrome. New England Journal of Medicine3411577\u20131581. (doi:10.1056\/NEJM199911183412104).","DOI":"10.1056\/NEJM199911183412104"},{"key":"2026070909381008400_bib57","doi-asserted-by":"crossref","unstructured":"Lamberts\n SW\n \n \n Bons\n EG\n \n \n Bruining\n HA\n \n \n de Jong\n FH\n \n \n 1987\n Differential effects of the imidazole derivatives etomidate, ketoconazole and miconazole and of metyrapone on the secretion of cortisol and its precursors by human adrenocortical cells. Journal of Pharmacology and Experimental Therapeutics240259\u2013264.","DOI":"10.1016\/S0022-3565(25)22688-X"},{"key":"2026070909381008400_bib58","doi-asserted-by":"crossref","unstructured":"Lamberts\n SW\n \n \n Uitterlinden\n P\n \n \n Klijn\n JM\n \n \n 1989\n The effect of the long-acting somatostatin analogue SMS 201-995 on ACTH secretion in Nelson's syndrome and Cushing's disease. Acta Endocrinologica120760\u2013766. (doi:10.1530\/acta.0.1200760).","DOI":"10.1530\/acta.0.1200760"},{"key":"2026070909381008400_bib59","doi-asserted-by":"crossref","unstructured":"van der Lely\n AJ\n \n \n Foeken\n K\n \n \n van der Mast\n RC\n \n \n Lamberts\n SW\n \n \n 1991\n Rapid reversal of acute psychosis in the Cushing syndrome with the cortisol-receptor antagonist mifepristone (RU 486). Annals of Internal Medicine114143\u2013144.","DOI":"10.7326\/0003-4819-114-2-143"},{"key":"2026070909381008400_bib60","unstructured":"Lindholm\n J\n \n \n Juul\n S\n \n \n Jorgensen\n JO\n \n \n Astrup\n J\n \n \n Bjerre\n P\n \n \n Feldt-Rasmussen\n U\n \n \n Hagen\n C\n \n \n Jorgensen\n J\n \n \n Kosteljanetz\n M\n \n \n Kristensen\n L\n \n \n \n 2001\n Incidence and late prognosis of Cushing's syndrome: a population-based study. Journal of Clinical Endocrinology and Metabolism86117\u2013123. 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Clinical Endocrinology27593\u2013599. (doi:10.1111\/j.1365-2265.1987.tb01189.x).","DOI":"10.1111\/j.1365-2265.1987.tb01189.x"},{"key":"2026070909381008400_bib64","doi-asserted-by":"crossref","unstructured":"McCormack\n AI\n \n \n Wass\n JA\n \n \n Grossman\n AB\n \n \n 2011\n Aggressive pituitary tumours: the role of temozolomide and the assessment of MGMT status. European Journal of Clinical Investigation411133\u20131148. (doi:10.1111\/j.1365-2362.2011.02520.x).","DOI":"10.1111\/j.1365-2362.2011.02520.x"},{"key":"2026070909381008400_bib65","doi-asserted-by":"crossref","unstructured":"Mohammed\n S\n \n \n Kovacs\n K\n \n \n Mason\n W\n \n \n Smyth\n H\n \n \n Cusimano\n MD\n \n \n 2009\n Use of temozolomide in aggressive pituitary tumors: case report. Neurosurgery64E773\u2013E774.(discussion E774) (doi:10.1227\/01.NEU.0000339115.12803.4E).","DOI":"10.1227\/01.NEU.0000339115.12803.4E"},{"key":"2026070909381008400_bib66","unstructured":"Morris\n D\n \n \n Grossman\n A\n \n \n 2002\n The medical management of Cushing's syndrome. Annals of the New York Academy of Sciences970119\u2013133. (doi:10.1111\/j.1749-6632.2002.tb04418.x)."},{"key":"2026070909381008400_bib67","doi-asserted-by":"crossref","unstructured":"Mullan\n KR\n \n \n Atkinson\n AB\n \n \n 2008\n Endocrine clinical update: where are we in the therapeutic management of pituitary-dependent hypercortisolism?\n Clinical Endocrinology\n 68\n 327\u2013337. (doi:10.1111\/j.1365-2265.2007.03028.x).","DOI":"10.1111\/j.1365-2265.2007.03028.x"},{"key":"2026070909381008400_bib68","doi-asserted-by":"crossref","unstructured":"Mullan\n KR\n \n \n Leslie\n H\n \n \n McCance\n DR\n \n \n Sheridan\n B\n \n \n Atkinson\n AB\n \n \n 2006\n The PPAR-\u03b3 activator rosiglitazone fails to lower plasma ACTH levels in patients with Nelson's syndrome. Clinical Endocrinology64519\u2013522. (doi:10.1111\/j.1365-2265.2006.02501.x).","DOI":"10.1111\/j.1365-2265.2006.02501.x"},{"key":"2026070909381008400_bib69","doi-asserted-by":"crossref","unstructured":"Munir\n A\n \n \n Song\n F\n \n \n Ince\n P\n \n \n Walters\n SJ\n \n \n Ross\n R\n \n \n Newell-Price\n J\n \n \n 2007\n Ineffectiveness of rosiglitazone therapy in Nelson's syndrome. Journal of Clinical Endocrinology and Metabolism921758\u20131763. (doi:10.1210\/jc.2006-2005).","DOI":"10.1210\/jc.2006-2005"},{"key":"2026070909381008400_bib70","unstructured":"Newell-Price\n J\n \n \n Bertagna\n X\n \n \n Grossman\n AB\n \n \n Nieman\n LK\n \n \n 2006\n Cushing's syndrome. Lancet3671605\u20131617. (doi:10.1016\/S0140-6736(06)68699-6)."},{"key":"2026070909381008400_bib71","unstructured":"Nieman\n LK\n \n \n 2002\n Medical therapy of Cushing's disease. Pituitary577\u201382. (doi:10.1023\/A:1022308429992)."},{"key":"2026070909381008400_bib72","doi-asserted-by":"crossref","unstructured":"Nieman\n LK\n \n \n Biller\n BM\n \n \n Findling\n JW\n \n \n Newell-Price\n J\n \n \n Savage\n MO\n \n \n Stewart\n PM\n \n \n Montori\n VM\n \n \n 2008\n The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism931526\u20131540. 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