Question: Dr. Geer, you reported on a multicenter study that included 230 Cushing’s disease (pituitary tumor) patients. What did you learn from this study? 

Answer: In the United States, there are few multi-center studies on treatment outcomes in patients with Cushing’s disease. We reviewed patient medical records from 8 diverse US pituitary/endocrine centers, including major referral centers and regional/local centers. The 230 patients included in the study were diagnosed less than 20 years ago and were over the age of 18; 79% were female. At diagnosis 67.7% had hypertension, 43.4 % had a diagnosis of PCOS and 41.4% had hyperlipidemia. Surprisingly, we found that initial pituitary surgery resulted in remission in only 41.4%, remission was not achieved in 50%, and not enough data was not available to determine remission status in 8.6%. Twenty seven percent of patients underwent more than one pituitary surgery. Medical treatment was used in 26.5%, radiation therapy in 12.6% and bilateral adrenalectomy in 7%. Despite these treatments, at the end of the follow up period (which varied across patients from 1 to 27.5 years, median 1.9 years), control of cortisol was achieved in only 49.1% (n=110), not achieved in 29.9% (67), and adequate data was not available to establish remission status in 21.0%. While this is a large study, because data were obtained from specific regional and tertiary care centers, this sample of patients may not be representative of the general patient population. However, this study does illustrate that long-term control is not achieved in many patients with CD, indicating the need for improvement in the care and long-term biochemical follow-up of this disorder.

Endo 2016: Biochemical Control during Long Term Follow up of 230 Patients with Cushing’s Disease: A Multi-Center Retrospective Study, Poster Board SAT 550

Authors: Eliza B. Geer*(1), Ismat Shafiq (2), Murray B Gordon (3), Vivien Bonert (4), Alejandro Ayala (5), Ronald S. Swerdloff (6), Laurence Katznelson (7), Yelena Lalazar (1), Ekaterina Manuylova (2), Karen J Pulaski-Liebert (8), John David Carmichael (9), Zeina Carolina Hannoush (5), Vijaya Surampudi (6), Michael S Broder (10), Dasha Cherepanov (10), Marianne Eagan (10), Jackie Lee (10), William H Ludlam (11), Maureen P Neary (11) and Beverly M.K. Biller (8)

1 Icahn School of Medicine at Mount Sinai, New York, NY, 2 University of Rochester School of Medicine and Dentistry, Rochester, NY, 3 Allegheny Neuroendocrinology Center, Allegheny General Hospital, Pittsburgh, PA, 4 Cedars-Sinai Medical Center, Los Angeles, CA, 5 University of Miami and Jackson Memorial Hospital, Miami, FL, 6 Harbor-UCLA Medical Center, Los Angeles, CA, 7 Stanford University, Stanford, CA, 8 Massachusetts General Hospital, Boston, MA, 9 University of Southern California, Los Angeles, CA, 10 Partnership for Health Analytic Research, LLC, Beverly Hills, CA, 11Novartis Pharmaceuticals Corporation, East Hanover, NJ

Newsletter: Summer, 2016