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). In particular, metyrapone, which affects cortisol secretion by inhibiting the 11β-hydroxylase enzyme (CYP11B1) ( 5 , 6 ), has a solid reputation of efficacy and entered clinical use since his introduction in 1958 ( 7 ); however, the drug has never
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Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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subjects pre-treated with metyrapone ( 28 ). In contrast to the expanding knowledge on ghrelin’s biological functions, the regulation of ghrelin’s synthesis and secretion is less well characterized, although involvement of the autonomic nervous system
Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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of the diagnosis of prostate neuroendocrine carcinoma, urgent treatment with inhibitors of adrenal steroidogenesis was initiated (ketoconazole, 1.2 g daily in divided doses and metyrapone 6 g daily in divided doses), along with mineralocorticoid
Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Krakow, Poland
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) Vertebral osteoporosis 2 (22) Unusual infections 1 (11) *ketoconazole or metyrapone, or osilodrostat or etomidate; **denotes ketoconazole, or metyrapone, or mitotane (in the case of adrenal carcinoma). TSS, transsphenoidal
Assistance Publique Hôpitaux de Paris (APHP), Department of Endocrinology and Diabetes for Children, Bicêtre Paris-Sud, Le Kremlin Bicêtre, France
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and metyrapone. Mitotane is approved for the treatment of adrenocortical carcinoma. It has been used as a cortisol-lowering drug for the treatment of CD in adults ( 27 , 28 , 29 , 30 , 31 ). A case report describes the use of mitotane for 18
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Impaired HPA feedback in cocaine habituated animals 28, 29 Synthesis blocked By metyrapone 50 mg/kg Reduced psychomotor effects of cocaine, and reduced reinstatement 196 By metyrapone 100 mg/kg Reduced psychomotor effects of cocaine, and reduced
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their partners ( 8 ). In another study, hydrocortisone administration during the quiescent phase in metyrapone-clamped volunteers reduced insulin sensitivity and glucose tolerance ( 31 ). However, in this study, serum cortisol levels reached about 800
Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, Spain
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results of postoperative basal cortisol, among which are: corticotropin-releasing hormone test ( 27 ), metyrapone test ( 28 ), desmopressin test ( 29 , 30 ) and dexamethasone suppression test after desmopressin ( 31 ). For the interpretation of these last
IRCCS, Istituto Auxologico Italiano, Milan, Italy
Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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Ceccato F Zilio M Barbot M Albiger N Antonelli G Plebani M Watutantrige-Fernando S Sabbadin C Boscaro M Scaroni C . Metyrapone treatment in Cushing’s syndrome: a real-life study . Endocrine 2018 62 701 – 711 . ( https://doi.org/10
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to CD. Cortisol-lowering medical treatment Eighty-four patients (38%) received pre-surgical cortisol-lowering medical treatment, the majority receiving metyrapone (68%) or ketoconazole (30%). Other used agents were osilodrostat (8%), mitotane