Modern views on Cushing’s disease treatment

Abstract

The aim. To choose the most optimal method of Cushing's disease (CD) therapy based on the clinical picture and the previous treatment efficacy. CD is a serious endocrine system disease caused by corticotropinoma or ectopic ACTH-producing adenoma. Taking into account the process localization in the central nervous system structures, the radical treatment is challenging. In addition, recurrence of the disease after surgical treatment is possible. The use of pharmacological drugs can not lead to the cause elimination in a form of tumor; however it is effective in preventing serious systemic complications. The review presents methods of radical and conservative CD treatment depending on the patient's condition severity, the size of tumor, the endocrine profile of organism and the presence of comorbidities. All currently used pharmacological agents have been characterized. The advantages of pasireotide in the selective blockade of somatostatin receptors in patients with CD have been shown. Conclusions. Treatment of CD is a complex problem, the solution of which depends on a number of factors (the condition severity, the size of tumor, the blood hormone levels, the presence of comorbidities, etc.). Several approaches to CD treatment are currently available – from conservative ones using modern quite effective drugs to radical surgical ones, when there is a need toexcise a tumor. The most effective drug for conservative CD therapy is pasireotide, which allows achieving clinical and laboratory remission and tumor size reduction.

Keywords

• hypophysieal acth hypersecration
• adrenocortical hyperfunction
• therapeutics