Abstract
Objective: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Methods: Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Results: Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Conclusion: Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-Term control is not achieved in a substantial number of patients with CD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 962-970 |
| Number of pages | 9 |
| Journal | Endocrine Practice |
| Volume | 23 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2017 |
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ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
Biochemical control during long-Term follow-up of 230 adult patients with cushing disease : A multicenter retrospective study. / Geer, Eliza B.; Shafiq, Ismat; Murray, B. Gordon; Bonert, Vivien; Ayala, Alejandro R; Swerdloff, Ronald S.; Katznelson, Laurence; Lalazar, Yelena; Manuylova, Ekaterina; Pulaski-Liebert, Karen J.; Carmichael, John D.; Hannoush, Zeina; Surampudi, Vijaya; Broder, Michael S.; Cherepanov, Dasha; Eagan, Marianne; Lee, Jackie; Said, Qayyim; Neary, Maureen P.; Biller, Beverly M.K.
In: Endocrine Practice, Vol. 23, No. 8, 01.08.2017, p. 962-970.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Biochemical control during long-Term follow-up of 230 adult patients with cushing disease
T2 - A multicenter retrospective study
AU - Geer, Eliza B.
AU - Shafiq, Ismat
AU - Murray, B. Gordon
AU - Bonert, Vivien
AU - Ayala, Alejandro R
AU - Swerdloff, Ronald S.
AU - Katznelson, Laurence
AU - Lalazar, Yelena
AU - Manuylova, Ekaterina
AU - Pulaski-Liebert, Karen J.
AU - Carmichael, John D.
AU - Hannoush, Zeina
AU - Surampudi, Vijaya
AU - Broder, Michael S.
AU - Cherepanov, Dasha
AU - Eagan, Marianne
AU - Lee, Jackie
AU - Said, Qayyim
AU - Neary, Maureen P.
AU - Biller, Beverly M.K.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objective: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Methods: Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Results: Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Conclusion: Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-Term control is not achieved in a substantial number of patients with CD.
AB - Objective: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Methods: Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Results: Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Conclusion: Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-Term control is not achieved in a substantial number of patients with CD.
UR - http://www.scopus.com/inward/record.url?scp=85029788866&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029788866&partnerID=8YFLogxK
U2 - 10.4158/EP171787.OR
DO - 10.4158/EP171787.OR
M3 - Article
VL - 23
SP - 962
EP - 970
JO - Endocrine Practice
JF - Endocrine Practice
SN - 1530-891X
IS - 8
ER -