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2013, Number 4

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Rev Endocrinol Nutr 2013; 21 (4)

Ketoconazole in the treatment of Cushing's disease

Espinosa-Cárdenas PE, Espinosa de los Monteros-Sánchez AL, Mercado M, Sosa-Eroza E

Language: Spanish
References: 22
Page: 164-170
PDF size: 200.15 Kb.


ABSTRACT

It is known that Cushing’s syndrome is a chronic, wasting and potentially lethal medical condition in which a systematic diagnostic approach is needed to identify the tumor causing the unrestricted cortisol secretion. Surgical resection leads to biochemical remission in a patient subset; however, a proportion of them will remain active. When surgery fails or it is contraindicated, a second-line therapy is needed. The options of medical therapy are described in this paper, emphasizing the role of ketoconazole, the only steroidogenic blocking drug available in Mexico. Ketoconazole has been used since the 1980’s for the treatment of hypercortisolism. We show the results of the published studies so far and describe our own experience at a referral center for Cushing’s syndrome. The use of ketoconazole has been reported to reach a rate of biochemical control of about 50% in most series and in some of them it exceeds 80%. We conclude that, with the available information, ketoconazole is a useful, reasonably safe and affordable option for the medical therapy of hypercortisolism.


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