Biochemical control during long-Term follow-up of 230 adult patients with cushing disease

A multicenter retrospective study

Eliza B. Geer, Ismat Shafiq, B. Gordon Murray, Vivien Bonert, Alejandro R Ayala, Ronald S. Swerdloff, Laurence Katznelson, Yelena Lalazar, Ekaterina Manuylova, Karen J. Pulaski-Liebert, John D. Carmichael, Zeina Hannoush, Vijaya Surampudi, Michael S. Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P. Neary, Beverly M.K. Biller

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)962-970
Number of pages9
JournalEndocrine Practice
Volume23
Issue number8
DOIs
StatePublished - Aug 1 2017

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Pituitary ACTH Hypersecretion
Multicenter Studies
Retrospective Studies
Pituitary Neoplasms
Comorbidity
Cost of Illness
Polycystic Ovary Syndrome
Hyperlipidemias
Adrenocorticotropic Hormone
Glucocorticoids
Signs and Symptoms

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 journalArticle

Geer, EB, Shafiq, I, Murray, BG, Bonert, V, Ayala, AR, Swerdloff, RS, Katznelson, L, Lalazar, Y, Manuylova, E, Pulaski-Liebert, KJ, Carmichael, JD, Hannoush, Z, Surampudi, V, Broder, MS, Cherepanov, D, Eagan, M, Lee, J, Said, Q, Neary, MP & Biller, BMK 2017, 'Biochemical control during long-Term follow-up of 230 adult patients with cushing disease: A multicenter retrospective study', Endocrine Practice, vol. 23, no. 8, pp. 962-970. https://doi.org/10.4158/EP171787.OR
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. / Biochemical control during long-Term follow-up of 230 adult patients with cushing disease : A multicenter retrospective study. In: Endocrine Practice. 2017 ; Vol. 23, No. 8. pp. 962-970.
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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.",
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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.

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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.

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