Metyrapone in endogenous Cushing’s syndrome management
Whatever its cause, the clinical consequences of endogenous Cushing’s syndrome are generally severe: glucose tolerance impairment or diabetes, hypertension, dyslipidemia, clotting disorders, vascular fragility, muscular weakness and osteoporosis, diminished resistance to infection, depression and psychiatric disorders, healing defects, gonadal dysfunction with hirsutism, acne. These multiple complications result in significant morbidity and impaired quality of life. Moreover inadequately controlled Cushing’s syndrome is a life-threatening condition, mostly as a result of increased cardiovascular risk.
Metopirone® (metyrapone 250 mg, soft capsules) is an inhibitor of the 11ß-hydroxylase enzyme in the adrenals and thereby blocks cortisol and aldosterone synthesis. Several retrospective studies and case reports have shown that metyrapone is effective in reducing cortisol levels in patients with Cushing’s syndrome of different etiologies.
An international phase 3 / 4 study has been initiated to prospectively confirm metyrapone efficacy and safety in patients with endogenous Cushing’s syndrome.