Alexandraki Krystallenia I, Grossman Ashley B
Professor of Neuroendocrinology St. Bartholomew's Hospital, Ashley Grossman FMedSci, London EC1A 7BE, UK.
Expert Opin Investig Drugs. 2008 May;17(5):669-77. doi: 10.1517/13543784.17.5.669.
The goals of ideal medical therapy for Cushing's disease should be to target the aetiology of the disorder, as is the case for surgery, which is the current 'gold standard' treatment. However, no effective drug that directly and reliably targets the adrenocorticotropin-secreting pituitary adenoma has yet been found.
To summarise pituitary-targeted medical treatment of Cushing's disease.
Compounds with neuromodulatory properties and ligands of different nuclear hormone receptors involved in hypothalamo-pituitary regulation have been investigated.
The somatostatin analogue pasireotide and the dopamine agonist cabergoline, as well as their combination, show some therapeutic promise in the medical therapy of Cushing's disease. Other treatments such as retinoic acid analogues look promising and may be a possible option for further investigation. No other medical therapies seem to be reliably effective currently.
Since a percentage of patients treated with surgery are not cured, or improve and subsequently relapse, there is an urgent need for effective medical therapies for this disorder. At present, only cabergoline and pasireotide are under active investigation.
库欣病理想的药物治疗目标应是针对该疾病的病因，就像手术那样，手术是目前的“金标准”治疗方法。然而，尚未找到能直接且可靠地作用于分泌促肾上腺皮质激素的垂体腺瘤的有效药物。
总结库欣病的垂体靶向药物治疗。
对具有神经调节特性的化合物以及参与下丘脑 - 垂体调节的不同核激素受体的配体进行了研究。
生长抑素类似物帕瑞肽和多巴胺激动剂卡麦角林，以及它们的联合使用，在库欣病的药物治疗中显示出一些治疗前景。其他治疗方法如维甲酸类似物看起来很有前景，可能是进一步研究的一个选择。目前似乎没有其他药物疗法能可靠地有效。
由于一部分接受手术治疗的患者未治愈，或病情改善后又复发，因此迫切需要针对这种疾病的有效药物疗法。目前，只有卡麦角林和帕瑞肽正在积极研究中。
