Suppr超能文献

美替拉酮与奥曲肽短期治疗内源性库欣综合征的比较:来自单中心队列研究的结果。

Metyrapone Versus Osilodrostat in the Short-Term Therapy of Endogenous Cushing's Syndrome: Results From a Single Center Cohort Study.

机构信息

Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital Würzburg, University of Würzburg, Würzburg, Germany.

Medicover Oldenburg MVZ, Oldenburg, Germany.

出版信息

Front Endocrinol (Lausanne). 2022 Jun 13;13:903545. doi: 10.3389/fendo.2022.903545. eCollection 2022.

Abstract

BACKGROUND

Although surgery is considered the first-line treatment for patients with endogenous Cushing's syndrome (CS), medical therapy is often required to control severe hypercortisolism. Metyrapone and osilodrostat are both steroidogenic inhibitors targeting the 11β-hydroxylase, however, their therapeutic effectiveness has not yet been directly compared. This study aimed to evaluate metyrapone and osilodrostat in the short-term therapy of CS.

METHODS

Retrospective analysis of patients with endogenous CS treated with metyrapone or osilodrostat as monotherapy for at least 4 weeks. Main outcome measures were serum cortisol and 24h urinary free cortisol (UFC) at baseline (T0) and after 2 (T1), 4 (T2), and 12 weeks (T3) of therapy.

RESULTS

16 patients with endogenous CS were identified (pituitary n=7, adrenal n=4, ectopic CS n=5). Each 8 patients were treated with metyrapone and osilodrostat. Despite heterogeneity, both groups showed comparable mean UFC levels at T0 (metyrapone: 758 µg/24h osilodrostat: 817 µg/24h; =0.93). From T0 to T1, the decrease of UFC was less pronounced under metyrapone than osilodrostat (-21.3% -68.4%; median daily drug dose: 1000 mg vs 4 mg). This tendency persisted at T2 (-37.3% vs -50.1%; median drug dose: 1250 mg 6 mg) while at T3 a decrease in UFC from T0 was more pronounced in the metyrapone group (-71.5% -51.5%; median dose 1250 mg 7 mg). Under osilodrostat, a QTc-interval prolongation was identified at T3 (mean 432 ms vs 455 ms). From T0 to T2, the number of antihypertensive drugs remained comparable under metyrapone and decreased under osilodrostat (n= -0.3 n= -1.0).

CONCLUSION

Although both drugs show comparable therapeutic efficacy, osilodrostat seems to reduce cortisol levels and to control blood pressure faster.

摘要

背景

尽管手术被认为是治疗内源性库欣综合征(CS)患者的一线治疗方法,但通常需要药物治疗来控制严重的皮质醇增多症。美替拉酮和奥昔拉酮都是针对 11β-羟化酶的甾体生成抑制剂,然而,它们的治疗效果尚未进行直接比较。本研究旨在评估美替拉酮和奥昔拉酮在 CS 的短期治疗中的作用。

方法

回顾性分析了至少接受美替拉酮或奥昔拉酮单药治疗 4 周以上的内源性 CS 患者。主要观察指标为治疗前(T0)、治疗后 2 周(T1)、4 周(T2)和 12 周(T3)时的血清皮质醇和 24 小时尿游离皮质醇(UFC)。

结果

共确定了 16 例内源性 CS 患者(垂体 n=7,肾上腺 n=4,异位 CS n=5)。每组 8 例患者分别接受美替拉酮和奥昔拉酮治疗。尽管存在异质性,但两组患者在 T0 时的 UFC 平均水平相似(美替拉酮:758μg/24h,奥昔拉酮:817μg/24h;=0.93)。从 T0 到 T1,美替拉酮组 UFC 的下降幅度小于奥昔拉酮组(-21.3%至-68.4%;中位数日剂量:1000mg 比 4mg)。这种趋势在 T2 时仍然存在(-37.3%至-50.1%;中位数药物剂量:1250mg 比 6mg),而在 T3 时,美替拉酮组从 T0 开始 UFC 的下降幅度更为明显(-71.5%至-51.5%;中位数剂量 1250mg 比 7mg)。在奥昔拉酮组中,T3 时 QTc 间期延长(平均 432ms 比 455ms)。从 T0 到 T2,美替拉酮组的降压药物数量保持不变,而奥昔拉酮组减少(n=-0.3 比 n=-1.0)。

结论

尽管两种药物的治疗效果相似,但奥昔拉酮似乎能更快地降低皮质醇水平并控制血压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a215/9235400/82806b0a25c6/fendo-13-903545-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验