{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:33:13Z","timestamp":1788381193342,"version":"build-2803163510"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although surgery is considered the first-line treatment for patients with endogenous Cushing\u2019s syndrome (CS), medical therapy is often required to control severe hypercortisolism. Metyrapone and osilodrostat are both steroidogenic inhibitors targeting the 11\u03b2-hydroxylase, however, their therapeutic effectiveness has not yet been directly compared. This study aimed to evaluate metyrapone and osilodrostat in the short-term therapy of CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of patients with endogenous CS treated with metyrapone or osilodrostat as monotherapy for at least 4 weeks. Main outcome measures were serum cortisol and 24h urinary free cortisol (UFC) at baseline (T0) and after 2 (T1), 4 (T2), and 12 weeks (T3) of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      16 patients with endogenous CS were identified (pituitary n=7, adrenal n=4, ectopic CS n=5). Each 8 patients were treated with metyrapone and osilodrostat. Despite heterogeneity, both groups showed comparable mean UFC levels at T0 (metyrapone: 758 \u00b5g\/24h\n                      <jats:italic>vs<\/jats:italic>\n                      osilodrostat: 817 \u00b5g\/24h;\n                      <jats:italic>p<\/jats:italic>\n                      =0.93). From T0 to T1, the decrease of UFC was less pronounced under metyrapone than osilodrostat (-21.3%\n                      <jats:italic>vs<\/jats:italic>\n                      -68.4%; median daily drug dose: 1000 mg vs 4 mg). This tendency persisted at T2 (-37.3% vs -50.1%; median drug dose: 1250 mg\n                      <jats:italic>vs<\/jats:italic>\n                      6 mg) while at T3 a decrease in UFC from T0 was more pronounced in the metyrapone group (-71.5%\n                      <jats:italic>vs<\/jats:italic>\n                      -51.5%; median dose 1250 mg\n                      <jats:italic>vs<\/jats:italic>\n                      7 mg). Under osilodrostat, a QTc-interval prolongation was identified at T3 (mean 432 ms vs 455 ms). From T0 to T2, the number of antihypertensive drugs remained comparable under metyrapone and decreased under osilodrostat (n= -0.3\n                      <jats:italic>vs<\/jats:italic>\n                      n= -1.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although both drugs show comparable therapeutic efficacy, osilodrostat seems to reduce cortisol levels and to control blood pressure faster.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2022.903545","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T09:06:42Z","timestamp":1655111202000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":36,"title":["Metyrapone Versus Osilodrostat in the Short-Term Therapy of Endogenous Cushing\u2019s Syndrome: Results From a Single Center Cohort 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