Mifepristone, a glucocorticoid receptor antagonist, produces clinical and metabolic benefits in patients with Cushing's syndrome
Abstract
CONTEXT: Cushing's syndrome (CS) is a disorder associated with significant morbidity and mortality due to prolonged exposure to high cortisol concentrations. OBJECTIVE: Our objective was to evaluate the safety and efficacy of mifepristone, a glucocorticoid receptor antagonist, in endogenous CS. DESIGN AND SETTING: We conducted a 24-wk multicenter, open-label trial after failed multimodality therapy at 14 U.S. academic medical centers and three private research centers. PARTICIPANTS: Participants included 50 adults with endogenous CS associated with type 2 diabetes mellitus/impaired glucose tolerance (C-DM) or a diagnosis of hypertension alone (C-HT). INTERVENTION: Mifepristone was administered at doses of 300-1200 mg daily. MAIN OUTCOME MEASURES: We evaluated change in area under the curve for glucose on 2-h oral glucose test for C-DM and change in diastolic blood pressure from baseline to wk 24 for C-HT. RESULTS: In the C-DM cohort, an area under the curve for glucose (AUC(glucose)) response was seen in 60% of patients (P < 0.0001). Mean ± sd glycated hemoglobin (HbA1c) decreased from 7.43 ± 1.52% to 6.29 ± 0.99% (P < 0.001); fasting plasma glucose decreased from 149.0 ± 75.7 mg/dl (8.3 ± 4.1 mmol/liter) to 104.7 ± 37.5 mg/dl (5.8 ± 2.1 mmol/liter, P < 0.03). In C-HT cohort, a diastolic blood pressure response was seen in 38% of patients (P < 0.05). Mean weight change was -5.7 ± 7.4% (P < 0.001) with waist circumference decrease of -6.78 ± 5.8 cm (P < 0.001) in women and -8.44 ± 5.9 cm (P < 0.001) in men. Overall, 87% (P < 0.0001) had significant improvement in clinical status. Insulin resistance, depression, cognition, and quality of life also improved. Common adverse events were fatigue, nausea, headache, low potassium, arthralgia, vomiting, edema, and endometrial thickening in women. CONCLUSIONS: Mifepristone produced significant clinical and metabolic improvement in patients with CS with an acceptable risk-benefit profile during 6 months of treatment.
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Overt adrenal insufficiency is rare under treatment with mifepristone.
“Overt adrenal insufficiency is rare under treatment with mifepristone (326).”
From Adrenocortical carcinoma (2014) · cites this paper as [326]
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“Moreover, increases in ACTH and cortisol levels can lead to (worsening of) mineralocorticoid effects (hypertension, edema, hypokalemia), and women can develop endometrial thickening during prolonged treatment.(141,142) Other agents currently under (preclinical) study for the medical control of hypercortisolemia includ…”
Potential functional and pathological side effects related to off-target pharmacological activity
Lynch, J. J., Vleet, T. R. V., Mittelstadt, S. W., & Blomme, E. A. G. (2017) · Journal of Pharmacological and Toxicological Methods · doi:10.1016/j.vascn.2017.02.020 · Cited by 97 · see citing works
Uterine Fibroids: Clinical Manifestations and Contemporary Management
Doherty, L. F., Mutlu, L., Sinclair, D., & Taylor, H. S. (2014) · Reproductive Sciences · doi:10.1177/1933719114533728 · Cited by 97 · see citing works
“The progestin effect of PR ligands can be assayed by the standard McPhail test (endometrial changes assessed after treatment of estrogen-primed rabbits) or more contemporary methods that assess in vitro transcriptional activity(167,168) Mifepristone is a PR ligand with pure antagonist activity that also has antiglucoc…”
MethodCOVID-19 and the Endocrine System: A Comprehensive Review on the Theme
Lisco, G., Tullio, A. D., Stragapede, A., Solimando, A. G., Albanese, F., Capobianco, M., Giagulli, V. A., Guastamacchia, E., Pergola, G. D., Vacca, A., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10132920 · Cited by 98 · see citing works
“Additionally, the use of systemic glucocorticoids, such as dexamethasone, in patients taking mifepristone, a glucocorticoid receptor antagonist, may be challenging as the latter reduces the efficacy of the former [66].”
BackgroundDodd, G. T., Xirouchaki, C. E., Eramo, M. J., Mitchell, C. A., Andrews, Z. B., Henry, B. A., Cowley, M. A., & Tiganis, T. (2019) · Cell Reports · doi:10.1016/j.celrep.2019.08.019 · Cited by 94 · see citing works
The Pathophysiology and Treatment of Hypertension in Patients With Cushing's Syndrome
Barbot, M., Ceccato, F., & Scaroni, C. M. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00321 · Cited by 94 · see citing works
ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of Cushing's syndrome
Newell-Price, J. D. C., Nieman, L. K., Reincke, M., & Tabarin, A. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0352 · Cited by 96 · see citing works
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A critical reappraisal of bilateral adrenalectomy for ACTH-dependent Cushing's syndrome
Reincke, M., Ritzel, K., Oßwald, A., Berr, C., Stalla, G. K., Hallfeldt, K. K. J., Reisch, N., Schopohl, J., & Beuschlein, F. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0265 · Cited by 91 · see citing works
Medical management of Cushing’s disease: what is the future?
Fleseriu, M., & Petersenn, S. (2012) · Pituitary · doi:10.1007/s11102-012-0397-5 · Cited by 88 · see citing works
“Bars indicate SEM [67] (mITT, modified intent to treat) (adapted from Fleseriu M, et al.”
BackgroundMethodInfluentialSelf-citationTHERAPY OF ENDOCRINE DISEASE: Steroidogenesis enzyme inhibitors in Cushing's syndrome
Daniel, E., & Newell-Price, J. D. C. (2015) · European Journal of Endocrinology · doi:10.1530/eje-14-1014 · Cited by 88 · see citing works
Fleseriu, M., Findling, J. W., Koch, C. A., Schlaffer, S.-M., Buchfelder, M., & Gross, C. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-1843 · Cited by 87 · see citing works
“8% of the 43 patients with CD experienced at least a 2-fold increase in ACTH (21).”
BackgroundMethodResultInfluentialSelf-citationRecent Updates on the Diagnosis and Management of Cushing's Syndrome
Nieman, L. K. (2018) · Endocrinology and Metabolism · doi:10.3803/enm.2018.33.2.139 · Cited by 85 · see citing works
Functioning Pituitary Adenomas – Current Treatment Options and Emerging Medical Therapies
Varlamov, E. V., McCartney, S., & Fleseriu, M. (2019) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2019.15.1.30 · Cited by 85 · see citing works
“Overall, a clinical response was observed in up to 87% of patients.(141) However, its mechanism of action causes ACTH and cortisol levels to rise during treatment, and therefore, they cannot be used to guide management; caution is required for potential tumour enlargement, especially in the case of macroadenomas.”
BackgroundSelf-citationPivonello, R., Bancos, I., Feelders, R. A., Kargi, A. Y., Kerr, J. M., Gordon, M. B., Mariash, C. N., Terzolo, M., Ellison, N., & Moraitis, A. G. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.662865 · Cited by 78 · see citing works
“In the 24-week SEISMIC study, 38.1% (8/21) of patients met the criteria for hypertension response, which for that trial was defined as a ≥5 mmHg reduction from baseline in DBP July 2021 | Volume 12 | Article 662865 assessed as the mean of 2 sequential clinic readings.”
BackgroundMethodResultInfluentialSelf-citationCarroll, T. B., Peppard, W., Herrmann, D. J., Javorsky, B. R., Wang, T. S., Patel, H., Zarnecki, K., & Findling, J. W. (2018) · Journal of the Endocrine Society · doi:10.1210/js.2018-00269 · Cited by 77 · see citing works
Self-citationKang, S., Tsai, L. T.-Y., Zhou, Y., Evertts, A. G., Xu, S., Griffin, M. J., Issner, R., Whitton, H. J., Garcia, B. A., Epstein, C. B., et al. (2014) · Nature Cell Biology · doi:10.1038/ncb3080 · Cited by 73 · see citing works
“Specifically, the first pathway involves the GR, which has been implicated in Dex-induced insulin resistance 41, 42 .”
BackgroundChitosan-based nanoparticles for improved anticancer efficacy and bioavailability of mifepristone
Zhang, H., Wu, F., Li, Y., Yang, X., Huang, J., Lv, T., Zhang, Y., Chen, J., Chen, H., Gao, Y., et al. (2016) · Beilstein Journal of Nanotechnology · doi:10.3762/bjnano.7.178 · Cited by 77 · see citing works
Diabetes Mellitus Secondary to Cushing’s Disease
Barbot, M., Ceccato, F., & Scaroni, C. M. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00284 · Cited by 78 · see citing works
“After 24 weeks of mifepristone treatment, fasting plasma glucose and HbA1c decreased, respectively, from 8.3 ± 4.1 to 5.8 ± 2.1 mmol/L and from 7.43 ± 1.52 to 6.29 ± 0.99%, leading to a reduction in the number of antidiabetic medications the patients were taking (99).”
BackgroundInfluentialA clinical perspective on ectopic Cushing’s syndrome
Ragnarsson, Ó., Juhlin, C. C., Torpy, D. J., & Falhammar, H. (2023) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2023.12.003 · Cited by 81 · see citing works
Cushing's syndrome: Treatment and new therapeutic approaches
Ferrière, A., & Tabarin, A. (2020) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2020.101381 · Cited by 76 · see citing works
Influence of glucocorticoids and growth hormone on insulin sensitivity in humans
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“More recently, pharmacological blockade of cortisol activity in active Cushing’s syndrome using mifepristone (a specific GC receptor antagonist) has been shown to lower fasting glucose and HbA1c concentration and improve glucose tolerance [116], substantiating the diabetogenic actions of chronic GC exposure.”
BackgroundAn individualized approach to the management of Cushing disease
Fleseriu, M., Varlamov, E., Hinojosa-Amaya, J. M., Langlois, F., & Melmed, S. (2023) · Nature Reviews Endocrinology · doi:10.1038/s41574-023-00868-7 · Cited by 59 · see citing works
Self-citationGlucocorticoids and cognitive function: a walkthrough in endogenous and exogenous alterations
Alcubierre, D. D., Ferrari, D., Mauro, G. C. D., Isidori, A. M., Tomlinson, J., & Pofi, R. (2023) · Journal of Endocrinological Investigation · doi:10.1007/s40618-023-02091-7 · Cited by 71 · see citing works
Bilateral adrenalectomy in the 21st century: when to use it for hypercortisolism?
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“Finally, Gagner et al. (1992) described the transperitoneal laparoscopic adrenalectomy, which has been improved since then and slightly modified by some teams with retroperitoneoscopy or robot-assisted surgery.”
BackgroundHunt, H., Belanoff, J. K., Walters, I. A. S., Gourdet, B., Thomas, J. A., Barton, N., Unitt, J. F., Phillips, T., Swift, D., & Eaton, E. (2017) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.7b00162 · Cited by 69 · see citing works
Fleseriu, M., Hamrahian, A. H., Hoffman, A. R., Kelly, D. F., & Katznelson, L. (2016) · Endocrine Practice · doi:10.4158/ep161512.dscr · Cited by 68 · see citing works
Self-citationManaging Cushing’s disease: the state of the art
Colao, A., Boscaro, M., Ferone, D., & Casanueva, F. F. (2014) · Endocrine · doi:10.1007/s12020-013-0129-2 · Cited by 66 · see citing works
“fepristone is a glucocorticoid-receptor antagonist shown to produce clinical and metabolic benefits in patients with Cushing’s disease over 6 months [123].”
BackgroundKiseljak-Vassiliades, K., Bancos, I., Hamrahian, A., Habra, M. A., Vaidya, A., Levine, A. C., & Else, T. (2020) · Endocrine Practice · doi:10.4158/dscr-2020-0567 · Cited by 66 · see citing works
“This often necessitates the use of spironolactone and/or potassium replacement (103).”
BackgroundSelf-citationEfficacy of medical treatment in C ushing's disease: a systematic review
Gadelha, M. R., & Neto, L. V. (2013) · Clinical Endocrinology · doi:10.1111/cen.12345 · Cited by 65 · see citing works
Glucocorticoid Withdrawal Syndrome following treatment of endogenous Cushing Syndrome
He, X., Findling, J. W., & Auchus, R. J. (2022) · Pituitary · doi:10.1007/s11102-022-01218-y · Cited by 68 · see citing works
Self-citationFleseriu, M., Molitch, M., Gross, C., Schteingart, D., Vaughan, T. B., & Biller, B. (2013) · Endocrine Practice · doi:10.4158/ep12149.ra · Cited by 55 · see citing works
Self-citationDebono, M., Chadarévian, R., Eastell, R., Ross, R. J. M., & Newell-Price, J. D. C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0060984 · Cited by 60 · see citing works
“These data support recent findings in a study in patients with overt Cushing’s syndrome where an improvement in insulin AUC and HOMA-IR was shown in the combined diabetes mellitus/impaired glucose tolerance and hypertension groups [12].”
BackgroundResultAcute stress is detrimental to heart regeneration in zebrafish
Sallin, P., & Jaźwińska, A. (2016) · Open Biology · doi:10.1098/rsob.160012 · Cited by 59 · see citing works
Future directions in the diagnosis and medical treatment of adrenocortical carcinoma
Creemers, S. G., Hofland, L. J., Korpershoek, E., Franssen, G. J. H., van Kemenade, F. J., de Herder, W. W., & Feelders, R. A. (2015) · Endocrine Related Cancer · doi:10.1530/erc-15-0452 · Cited by 59 · see citing works
“Mifepristone, a glucocorticoid receptor antagonist, is another treatment modality for excess cortisol levels (Fleseriu et al. 2012).”
BackgroundVarlamov, E. V., Langlois, F., Vila, G., & Fleseriu, M. (2021) · European Journal of Endocrinology · doi:10.1530/eje-20-1309 · Cited by 58 · see citing works
Self-citationHu, P., Oomen, C. A., van Dam, A., Wester, J., Zhou, J., Joëls, M., & Lucassen, P. J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0046224 · Cited by 58 · see citing works
“We nevertheless decided to use this drug, to allow easy comparison with earlier studies in rats and men [11,12,13,14,35,36,51,52,53,54,55,56,57].”
Treatment of Cushing's disease: a mechanistic update
Ramos, D. C., & Fleseriu, M. (2014) · Journal of Endocrinology · doi:10.1530/joe-14-0300 · Cited by 55 · see citing works
Self-citationGlucocorticoid excess and COVID-19 disease
Guarnotta, V., Ferrigno, R., Martino, M., Barbot, M., Isidori, A. M., Scaroni, C. M., Ferrante, A., Arnaldi, G., Pivonello, R., & Giordano, C. S. D. S. (2020) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-020-09598-x · Cited by 55 · see citing works
Mifepristone for Management of C ushing's Syndrome
Morgan, F. H., & Laufgraben, M. J. (2013) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.1202 · Cited by 56 · see citing works
“In the patients with Cushing’s disease, magnetic resonance imaging demonstrated stability of the pituitary tumor, with the exception of one patient with an aggressive tumor.(37) Limitations of this multicenter study include a relatively high dropout rate, lack of a placebo group, short study duration, and open-label d…”
BackgroundMethodInfluentialCurrent management of Cushing's disease
Tritos, N. A., & Biller, B. M. K. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12975 · Cited by 56 · see citing works
Self-citationStructural insights into glucocorticoid receptor function
Frank, F., Ortlund, E. A., & Liu, X. (2021) · Biochemical Society Transactions · doi:10.1042/bst20210419 · Cited by 54 · see citing works
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“The Study of the Efficacy and Safety of Mifepristone in the Treatment of Endogenous Cushing’s Syndrome demonstrated improvement in diabetes and hypertension in 60% and 40% of CS patients, respectively [249].”
BackgroundMethodKeller-Wood, M., Feng, X.-D., Wood, C., Richards, E., Anthony, R., Dahl, G., & Tao, S. (2014) · American Journal of Physiology. Regulatory Integrative and Comparative Physiology · doi:10.1152/ajpregu.00530.2013 · Cited by 51 · see citing works
Therapeutic Strategies for the Treatment of Severe Cushing’s Syndrome
Alexandraki, K., & Grossman, A. B. (2016) · Drugs · doi:10.1007/s40265-016-0539-6 · Cited by 52 · see citing works
“Mifepristone binds to GR with an 18-fold higher affinity than cortisol [53], resulting in a loss of negative feedback effects at the HPA by cortisol, leading to an increase in ACTH secretion in CD with a concomitantly increased cortisol production [23].”
Impact of Adrenal Steroids on Regulation of Adipose Tissue
Infante, M., Armani, A., Mammi, C., Fabbri, A., & Caprio, M. (2017) · Comprehensive physiology · doi:10.1002/cphy.c160037 · Cited by 52 · see citing works
Cushing's disease: a multidisciplinary overview of the clinical features, diagnosis, and treatment.
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Simeoli, C., Auriemma, R. S., Tortora, F., Leo, M. D., Iacuaniello, D., Cozzolino, A., Martino, M. C. D., Pivonello, C., Mainolfi, C. G., Rossi, R., et al. (2015) · Endocrine · doi:10.1007/s12020-015-0557-2 · Cited by 50 · see citing works
Fallo, F., Dalmazi, G. D., Beuschlein, F., Biermasz, N. R., Castinetti, F., Elenkova, A. P., Faßnacht, M., Isidori, A. M., Kaštelan, D., Korbonits, M., et al. (2022) · Journal of Hypertension · doi:10.1097/hjh.0000000000003252 · Cited by 48 · see citing works
“However, in larger cohorts of Cushing’s syndrome patients, hypertension was an adverse event of treatment with ketoconazole alone, metyrapone alone, or with their combination in 48% of the cases overall [189], with osilodrostat in 12% [171], and with mifepristone in 24% [190].”
BackgroundResetting the Stress System with a Mifepristone Challenge
Dalm, S., Karssen, A. M., Meijer, O. C., Belanoff, J. K., & de Kloet, E. R. (2018) · Cellular and Molecular Neurobiology · doi:10.1007/s10571-018-0614-5 · Cited by 47 · see citing works
Hypertension and Cardiovascular Mortality in Patients with Cushing Syndrome
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Quality of Life in Patients With Cushing's Disease
Vives, A. S., Resmini, E., Martínez-Momblán, M.-A., Valassi, E., Martel‐Duguech, L., & Webb, S. M. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00862 · Cited by 48 · see citing works
“Twenty-four-week treatment with mifepristone in CS has also been shown to improve the mental and physical scores of SF-36 and depression, measured by BDI-II (48).”
MethodWang, J., Chen, J., Wan, L., Shao, J., Lu, Y., Zhu, Y., Ou, M., Yu, S., Chen, H., & Jia, L. (2014) · The AAPS Journal · doi:10.1208/s12248-013-9559-2 · Cited by 47 · see citing works
“mifepristone, may be a good candidate for further investigation for the following reasons: (1) The patentable metapristone is the primary metabolite of mifepristone.”
InfluentialEGFR Induces E2F1-Mediated Corticotroph Tumorigenesis
Araki, T., Liu, X., Kameda, H., Tone, Y., Fukuoka, H., Tone, M., & Melmed, S. K. (2017) · Journal of the Endocrine Society · doi:10.1210/js.2016-1053 · Cited by 47 · see citing works
Cushing’s Syndrome Effects on the Thyroid
Paragliola, R., Corsello, A., Papi, G., Pontecorvi, A., & Corsello, S. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22063131 · Cited by 38 · see citing works
“A clinical trial evaluating the safety and efficacy of mifepristone in endogenous CS found that eight of 42 patients had reversible increases in TSH during the treatment [73], which normalized six weeks after mifepristone discontinuation.”
BackgroundMel'nichenko, G. A., Dedov, I. I., Belaya, Z. E., Rozhinskaya, L. Y., Vagapova, G. R., Волкова, Н. И., Grigor’ev, A. Y., Grineva, E. N., Marova, E. I., Mkrtumayn, A. M., et al. (2015) · Problems of Endocrinology · doi:10.14341/probl201561255-77 · Cited by 50 · see citing works
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Modern management of mild autonomous cortisol secretion
Delivanis, D. A., Athimulam, S., & Bancos, I. (2019) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.1551 · Cited by 46 · see citing works
“Several large prospective studies are currently ongoing within the ENSAT community and in the United States.6,71 In the future, it is likely that in order to individualize therapy, a panel of multiple noninvasive biomarkers will be used to accurately diagnose patients with clinically relevant MACS.”
BackgroundInfluentialGlobal clinical response in C ushing's syndrome patients treated with mifepristone
Katznelson, L. J., Loriaux, D. L., Feldman, D., Braunstein, G. D., SCHTEINGART, D. E., & Gross, C. (2013) · Clinical Endocrinology · doi:10.1111/cen.12332 · Cited by 45 · see citing works
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Tritos, N. A., & Biller, B. M. K. (2014) · Handbook of clinical neurology · doi:10.1016/b978-0-444-59602-4.00015-0 · Cited by 45 · see citing works
Self-citation
- Authors
- Fleseriu, M., Biller, B. M. K., Findling, J. W., Molitch, M. E., Schteingart, D. E., Gross, C., on behalf of the SEISMIC Study Investigators, The SEISMIC Study Investigators include, Auchus, R., Bailey, T., Biller, B. M. K., Carroll, T., Colleran, K., Fein, H., Findling, J. W., Fleseriu, M., Hamrahian, A., Katznelson, L., Kerr, J., Kipnes, M., Kirschner, L., Koch, C., Lerman, S., Lyons, T., McPhaul, M., Molitch, M. E., Schteingart, D. E., Vaughan, T. B., & Weiss, R.
- Affiliations
- Corcept Therapeutics (United States) (US)
- The University of Texas Southwestern Medical Center (US)
- AMCR Institute (US)
- Massachusetts General Hospital (US)
- Medical College of Wisconsin (US)
- Oregon Health & Science University (US)
- Cleveland Clinic (US)
- Northwestern University (US)
- The Ohio State University Wexner Medical Center (US)
- University of Mississippi Medical Center (US)
- University of Michigan (US)
- University of Alabama at Birmingham (US)
- University of Chicago (US)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-06-01
- Volume
- 97
- Issue
- 6
- Pages
- 2039-2049
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2021271765
- Semantic Scholar
- 40d98664c0987b1bdf2cbb43dbea52247bf04f70
- Cited by
- 479
- References
- 45
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 22 · 2023: 28 · 2022: 33 · 2021: 29 · 2020: 30 · 2019: 41 · 2018: 35 · 2017: 35 · 2016: 38 · 2015: 45 · 2014: 39 · 2013: 39 · 2012: 16
- FWCI
- 35.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Keywords
- mifepristone, Cushing's syndrome, glucocorticoid receptor antagonist, type 2 diabetes, impaired glucose tolerance, hypertension, glycemic control, HbA1c, insulin resistance, blood pressure, weight loss, waist circumference, adverse events, drug safety, quality of life, depression, cognitive function
- MeSH terms
- Adult, Antihypertensive Agents, Blood Glucose, Blood Pressure, Body Composition, Body Weight, Cushing Syndrome, Diabetes Mellitus, Type 2, Female, Hormone Antagonists, Humans, Hydrocortisone, Hypertension, Male, Middle Aged, Quality of Life, Quinolines, Receptors, Glucocorticoid, Urea, Mifepristone, Glucose Intolerance
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