The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study
Objective. This prospective open trial aimed to evaluate the efficacy and safety of isotretinoin (13-cis-retinoic acid) in patients with Cushing’s disease (CD). Methods. Sixteen patients with CD and persistent or recurrent hypercortisolism after transsphenoidal surgery were given isotretinoin orally...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2016/8173182 |
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| author | Lucio Vilar José Luciano Albuquerque Ruy Lyra Erik Trovão Diniz Frederico Rangel Filho Patrícia Gadelha Ana Carolina Thé George Robson Ibiapina Barbara Sales Gomes Vera Santos Maíra Melo da Fonseca Karoline Frasão Viana Isis Gabriella Lopes Douglas Araújo Luciana Naves |
| author_facet | Lucio Vilar José Luciano Albuquerque Ruy Lyra Erik Trovão Diniz Frederico Rangel Filho Patrícia Gadelha Ana Carolina Thé George Robson Ibiapina Barbara Sales Gomes Vera Santos Maíra Melo da Fonseca Karoline Frasão Viana Isis Gabriella Lopes Douglas Araújo Luciana Naves |
| author_sort | Lucio Vilar |
| collection | DOAJ |
| description | Objective. This prospective open trial aimed to evaluate the efficacy and safety of isotretinoin (13-cis-retinoic acid) in patients with Cushing’s disease (CD). Methods. Sixteen patients with CD and persistent or recurrent hypercortisolism after transsphenoidal surgery were given isotretinoin orally for 6–12 months. The drug was started on 20 mg daily and the dosage was increased up to 80 mg daily if needed and tolerated. Clinical, biochemical, and hormonal parameters were evaluated at baseline and monthly for 6–12 months. Results. Of the 16 subjects, 4% (25%) persisted with normal urinary free cortisol (UFC) levels at the end of the study. UFC reductions of up to 52.1% were found in the rest. Only patients with UFC levels below 2.5-fold of the upper limit of normal achieved sustained UFC normalization. Improvements of clinical and biochemical parameters were also noted mostly in responsive patients. Typical isotretinoin side-effects were experienced by 7 patients (43.7%), though they were mild and mostly transient. We also observed that the combination of isotretinoin with cabergoline, in relatively low doses, may occasionally be more effective than either drug alone. Conclusions. Isotretinoin may be an effective and safe therapy for some CD patients, particularly those with mild hypercortisolism. |
| format | Article |
| id | doaj-art-c033f18cef9e488ba6b060881cd430a0 |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-c033f18cef9e488ba6b060881cd430a02025-08-20T02:19:26ZengWileyInternational Journal of Endocrinology1687-83371687-83452016-01-01201610.1155/2016/81731828173182The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective StudyLucio Vilar0José Luciano Albuquerque1Ruy Lyra2Erik Trovão Diniz3Frederico Rangel Filho4Patrícia Gadelha5Ana Carolina Thé6George Robson Ibiapina7Barbara Sales Gomes8Vera Santos9Maíra Melo da Fonseca10Karoline Frasão Viana11Isis Gabriella Lopes12Douglas Araújo13Luciana Naves14Division of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Hospital das Clínicas, Pernambuco Federal University, Avenida Professor Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, BrazilDivision of Endocrinology, Brasilia University Hospital, Brasilia, DF, BrazilObjective. This prospective open trial aimed to evaluate the efficacy and safety of isotretinoin (13-cis-retinoic acid) in patients with Cushing’s disease (CD). Methods. Sixteen patients with CD and persistent or recurrent hypercortisolism after transsphenoidal surgery were given isotretinoin orally for 6–12 months. The drug was started on 20 mg daily and the dosage was increased up to 80 mg daily if needed and tolerated. Clinical, biochemical, and hormonal parameters were evaluated at baseline and monthly for 6–12 months. Results. Of the 16 subjects, 4% (25%) persisted with normal urinary free cortisol (UFC) levels at the end of the study. UFC reductions of up to 52.1% were found in the rest. Only patients with UFC levels below 2.5-fold of the upper limit of normal achieved sustained UFC normalization. Improvements of clinical and biochemical parameters were also noted mostly in responsive patients. Typical isotretinoin side-effects were experienced by 7 patients (43.7%), though they were mild and mostly transient. We also observed that the combination of isotretinoin with cabergoline, in relatively low doses, may occasionally be more effective than either drug alone. Conclusions. Isotretinoin may be an effective and safe therapy for some CD patients, particularly those with mild hypercortisolism.http://dx.doi.org/10.1155/2016/8173182 |
| spellingShingle | Lucio Vilar José Luciano Albuquerque Ruy Lyra Erik Trovão Diniz Frederico Rangel Filho Patrícia Gadelha Ana Carolina Thé George Robson Ibiapina Barbara Sales Gomes Vera Santos Maíra Melo da Fonseca Karoline Frasão Viana Isis Gabriella Lopes Douglas Araújo Luciana Naves The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study International Journal of Endocrinology |
| title | The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study |
| title_full | The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study |
| title_fullStr | The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study |
| title_full_unstemmed | The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study |
| title_short | The Role of Isotretinoin Therapy for Cushing’s Disease: Results of a Prospective Study |
| title_sort | role of isotretinoin therapy for cushing s disease results of a prospective study |
| url | http://dx.doi.org/10.1155/2016/8173182 |
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