Advances in pharmacological treatment of Cushing's disease
Cushing's disease is a rare endocrine disorder characterized by hypercortisolism.Chronic elevated cortisol levels can lead to dysfunction or complications in multiple organs of systems,including cardiovascular,glucose,and bone metabolism,severely impacting patients'quality of life and posing life-threatening risks.Surgery is the first-line treatment for Cushing's disease.However,in cases of delayed diagnosis,surgical contraindications,or suboptimal surgical outcomes,pharmacological therapy is often required.Currently,three categories of medications are commonly used:1)Drugs targeting somatostatin and/or dopamine receptors to inhibit pituitary adrenocorticotropic hormone(ACTH)synthesis(e.g.,pasireotide,cabergoline);2)drugs targeting adrenal cortex-related receptors to suppress steroid synthesis(e.g.,ketoconazole,metyrapone,mitotane,and osilodrostat);3)drugs acting on glucocorticoid receptors(e.g.,mifepristone).Research on pharmacological treatments for Cushing's disease is ongoing,with new drugs such as seliciclib,CRN04894,fimepinostat,vorinostat,and SPI-62 currently in phase Ⅱ clinical trial.The development of novel drugs holds promise for more precise and effective treatment for Cushing's disease patients.
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