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Annual Review of Medicine

Volume 76, 2025

New Approaches to the Treatment of Hypercortisolism

  • Riccardo Pofi1, Dario De Alcubierre2, Jiawen Dong1 and Jeremy W. Tomlinson1
  • 1Oxford Centre for Diabetes, Endocrinology and Metabolism and National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, United Kingdom; email: [email protected] 2Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
  • Vol. 76:431-445 (Volume publication date January 2025)
  • First published as a Review in Advance on November 01, 2024
  • Copyright © 2025 by the author(s).
    This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information.

Abstract

This review explores the evolving landscape of treatments for hypercortisolism, highlighting both established and emerging therapies. Although surgery remains the cornerstone of management, medical therapies play a crucial and expanding role, especially in cases of persistent, recurrent, or severe hypercortisolism. We discuss the effectiveness and limitations of steroidogenesis inhibitors, pituitary-directed drugs, glucocorticoid receptor antagonists, and experimental drugs targeting novel molecular pathways that have been implicated in the pathogenesis of hypercortisolism. Despite advancements, significant unmet needs persist, underscoring the importance of personalized treatment approaches and the development of targeted therapies. Ongoing and future clinical trials are crucial for validating the safety and efficacy of these innovative treatments in Cushing disease management.

Keyword(s): adrenal, cortisol, Cushing syndrome, pituitary
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2025-01-27
2025-06-23
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New Approaches to the Treatment of Hypercortisolism
Annual Review of Medicine 76, 431 (2025); https://doi.org/10.1146/annurev-med-071723-044849
/content/journals/10.1146/annurev-med-071723-044849
/content/journals/10.1146/annurev-med-071723-044849
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