Page last updated: 2024-10-31

mitotane and Pituitary ACTH Hypersecretion

mitotane has been researched along with Pituitary ACTH Hypersecretion in 14 studies

Mitotane: A derivative of the insecticide DICHLORODIPHENYLDICHLOROETHANE that specifically inhibits cells of the adrenal cortex and their production of hormones. It is used to treat adrenocortical tumors and causes CNS damage, but no bone marrow depression.

Pituitary ACTH Hypersecretion: A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME.

Research Excerpts

ExcerptRelevanceReference
"Mitotane is an adrenolytic and anticortisolic drug used in adrenocortical carcinoma (ACC), Cushing's disease (CD), and ectopic ACTH syndrome."7.81Ovarian macrocysts and gonadotrope-ovarian axis disruption in premenopausal women receiving mitotane for adrenocortical carcinoma or Cushing's disease. ( Bachelot, A; Baudin, E; Bernard, V; Bry-Gauillard, H; Chanson, P; Crinière, L; Do Cao, C; Droumaguet, C; Guignat, L; Leboulleux, S; Maiter, D; Pierre, P; Salenave, S; Santulli, P; Schlumberger, M; Touraine, P; Young, J, 2015)
"Mitotane is an adrenolytic and anticortisolic drug used in adrenocortical carcinoma (ACC), Cushing's disease (CD), and ectopic ACTH syndrome."3.81Ovarian macrocysts and gonadotrope-ovarian axis disruption in premenopausal women receiving mitotane for adrenocortical carcinoma or Cushing's disease. ( Bachelot, A; Baudin, E; Bernard, V; Bry-Gauillard, H; Chanson, P; Crinière, L; Do Cao, C; Droumaguet, C; Guignat, L; Leboulleux, S; Maiter, D; Pierre, P; Salenave, S; Santulli, P; Schlumberger, M; Touraine, P; Young, J, 2015)
"Medical therapy to control hypercortisolism in adrenal Cushing's syndrome is currently not the first-line therapy."2.66What is the role of medical therapy in adrenal-dependent Cushing's syndrome? ( Braun, LT; Reincke, M, 2020)
"Medical therapy for Cushing disease is primarily used to control hypercortisolism in patients whose disease persists or with recurrent disease after pituitary surgery, including those awaiting the salutary effects of radiation therapy."2.61Medical Management of Cushing Disease. ( Biller, BMK; Tritos, NA, 2019)
"OBJECT Cushing's disease (CD) can lead to significant morbidity secondary to hormonal sequelae or mass effect from the pituitary tumor."2.52Cushing's disease: current medical therapies and molecular insights guiding future therapies. ( Aghi, MK; Lau, D; Rutledge, C, 2015)
"Pasireotide was the only treatment to be assessed in a randomized trial and was supported by a 'moderate' level of evidence."2.50Efficacy of medical treatment in Cushing's disease: a systematic review. ( Gadelha, MR; Vieira Neto, L, 2014)
"Hypercortisolism induced by Cushing disease causes high morbidity and mortality."2.48New prospects for drug treatment in Cushing disease. ( Barahona Constanzo, MJ; del Pozo Picó, C, 2012)
"The goals of ideal medical therapy for Cushing's disease should be to target the aetiology of the disorder, and thus surgery is the current 'gold standard' treatment."2.46Medical therapy of Cushing's disease: where are we now? ( Alexandraki, KI; Grossman, AB, 2010)
"Medical therapy for Cushing's disease (CD) is currently based on agents mainly targeting adrenocortical function."1.39Mitotane reduces human and mouse ACTH-secreting pituitary cell viability and function. ( Ambrosio, MR; Degli Uberti, EC; Gentilin, E; Lapparelli, M; Minoia, M; Tagliati, F; Terzolo, M; Zatelli, MC; Zoli, M, 2013)
"Mitotane is a potent anti-cortisolic drug but has been rarely investigated in the treatment of CD."1.38Efficiency and tolerance of mitotane in Cushing's disease in 76 patients from a single center. ( Abbas, H; Baudry, C; Bertagna, X; Bertherat, J; Bou Khalil, R; Coste, J; Guibourdenche, J; Guignat, L; Legmann, P; Silvera, S, 2012)

Research

Studies (14)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's0 (0.00)29.6817
2010's11 (78.57)24.3611
2020's3 (21.43)2.80

Authors

AuthorsStudies
Golinelli, S1
Fracassi, F1
Bianchi, E1
Pöppl, ÁG1
Miceli, DD1
Benedicenti, L1
De Marco, V1
Cook, AK1
Espada Castro, L1
Ramsey, I1
Seo, KW1
Cantile, C1
Gandini, G1
Hulsebosch, SE1
Feldman, EC1
Tritos, NA2
Biller, BMK2
Braun, LT1
Reincke, M1
Gentilin, E1
Tagliati, F1
Terzolo, M1
Zoli, M1
Lapparelli, M1
Minoia, M1
Ambrosio, MR1
Degli Uberti, EC1
Zatelli, MC1
Gadelha, MR1
Vieira Neto, L1
Broder, MS1
Neary, MP1
Chang, E1
Cherepanov, D1
Sun, GH1
Ludlam, WH1
Salenave, S1
Bernard, V1
Do Cao, C1
Guignat, L2
Bachelot, A1
Leboulleux, S1
Droumaguet, C1
Bry-Gauillard, H1
Pierre, P1
Crinière, L1
Santulli, P1
Touraine, P1
Chanson, P1
Schlumberger, M1
Maiter, D1
Baudin, E1
Young, J1
Lau, D1
Rutledge, C1
Aghi, MK1
Murao, K1
Imachi, H1
Ishida, T1
Hosomi, N1
Masugata, H1
Alexandraki, KI1
Grossman, AB1
Baudry, C1
Coste, J1
Bou Khalil, R1
Silvera, S1
Guibourdenche, J1
Abbas, H1
Legmann, P1
Bertagna, X1
Bertherat, J1
Barahona Constanzo, MJ1
del Pozo Picó, C1
Feelders, RA1
Hofland, LJ1

Clinical Trials (1)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Glucocorticoid Receptor Blockade With Mifepristone in Patients With Mild Adrenal Hypercortisolism[NCT01990560]Phase 48 participants (Actual)Interventional2013-11-30Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

A1C Level

Change in hyperglycemia assessed by HbA1c, also known as glycated hemoglobin (NCT01990560)
Timeframe: Baseline, 3 months, and 6 months

Interventionpercentage of red blood cells (Mean)
Baseline3 months6 months
Mifepristone6.26.13756.125

Body Mass Index (BMI)

Change in metabolic syndrome as assessed by BMI (NCT01990560)
Timeframe: Baseline and 6 months

Interventionkg/m2 (Mean)
Baseline6 months
Mifepristone35.153834.5463

CushingQoL

Change in Quality of Life - as assessed by the Cushing's Quality of Life questionnaire (CushingQoL). Patient completed questionnaire, 12 items, each scored on a 5 point score, resulting in a score of 12 (worst) to 60 (best) where higher scores indicate more favorable QOL. (NCT01990560)
Timeframe: Baseline and 6 months

Interventionunits on a scale (Mean)
Baseline6 months
Mifepristone37.285738.7857

Fasting Lipid Profile

Change in metabolic syndrome as assessed by fasting lipid profile which includes Low-density lipoproteins ( LDL), High-density lipoproteins (HDL), and Triglycerides (Trigs) levels, and total cholesterol which is the sum of HDL plus LDL and 20% of trigs. (NCT01990560)
Timeframe: Baseline and 6 months

Interventionmg/dL (Mean)
Total Cholesterol BaselineTotal Cholesterol 6 monthsLDL baselineLDL 6 monthsHDL BaselineHDL 6 monthsTrigs BaselineTrigs 6 months
Mifepristone178.63171.4397.88104.3759.1346.86107.88100.29

HOMA-IR

Change in hyperglycemia assessed by Homeostatic Model Assessment of Insulin Resistance, HOMA-IR (a validated assessment of insulin resistance). HOMA-IR = fasting insulin (microU/L) x fasting glucose (nmol/L)/22.5. (NCT01990560)
Timeframe: Baseline and 6 months

InterventionHOMA-IR score (Mean)
Baseline6 months
Mifepristone2.4181.465

Hospital Anxiety and Depression Scale (HADS)

Change in Quality of Life as assessed by the Hospital Anxiety and Depression Scale (HADS). Questionnaire with 7 items for anxiety and 7 items for depression, each item is scored on a 4 point response 0 - 3, with full range from 0 to 42, with higher score indicating more severe anxiety or depression (NCT01990560)
Timeframe: Baseline and 6 months

Interventionunits on a scale (Mean)
Baseline6 months
Mifepristone16.285711.1667

Nottingham Health Profile (NHP)

Change in Quality of Life as assessed by the Nottingham Health Profile (NHP) which is a patient reported questionnaire to measure a patient's view of their own health status. There are 6 sections (Energy level, Pain, Emotional Reaction, Sleep, Social Isolation, and Physical Abilities. All questions have only yes/no answer options and each section score is weighted so that the possible score range for any section is 0-100. The higher the score, the greater the number and severity of problems. (NCT01990560)
Timeframe: Baseline and 6 months

Interventionunits on a scale (Mean)
Energy Level (EL) BaselineEL 6 monthsPain (P) BaselineP 6 monthsEmotional Reaction (ER) BaselineER 6 monthsSleep (S) BaselineS 6 monthsSocial Isolation (SI) BaselineSI 6 monthsPhysical Abilities (PA) BaselinePA 6 months
Mifepristone32.6045.4024.8832.0827.0335.0924.8731.1520.0931.1523.0627.49

Quality of Life

Change in Quality of Life as assessed by the Beck Depression Inventory. a 21-question multiple choice, self-report inventory that is used for measuring the severity of anxiety. Scoring is from a 0 (not at all) to 3 (severe) with a total score range of 0-63. Higher total scores indicate more severe anxiety symptoms. (NCT01990560)
Timeframe: Baseline and 6 months

Interventionunits on a scale (Mean)
Baseline6 months
Mifepristone16.142911.7143

State Trait Anxiety Inventory (STAI)

Change in Quality of Life - as assessed by the State Trait Anxiety Inventory (STAI). The State-Trait Anxiety Inventory both state and trait anxiety separately. Each type of anxiety has its own scale of 20 different questions that are scored and averaged. Total scores range from 20 to 80, with higher scores correlating with greater anxiety. (NCT01990560)
Timeframe: Baseline and 6 months

Interventionunits on a scale (Mean)
Baseline6 months
Mifepristone25.428628.8571

Waist Circumference

Change in metabolic syndrome as assessed by waist circumference (NCT01990560)
Timeframe: Baseline and 6 months

Interventioncm (Mean)
Baseline6 months
Mifepristone103.2599.3125

Weight

Change in metabolic syndrome as assessed by weight (NCT01990560)
Timeframe: Baseline and 6 months

Interventionkg (Mean)
Baseline6 months
Mifepristone99.5797.75

Reviews

8 reviews available for mitotane and Pituitary ACTH Hypersecretion

ArticleYear
Medical Management of Cushing Disease.
    Neurosurgery clinics of North America, 2019, Volume: 30, Issue:4

    Topics: Cabergoline; Etomidate; Humans; Ketoconazole; Metyrapone; Mitotane; Pituitary ACTH Hypersecretion; S

2019
What is the role of medical therapy in adrenal-dependent Cushing's syndrome?
    Best practice & research. Clinical endocrinology & metabolism, 2020, Volume: 34, Issue:3

    Topics: Adrenal Gland Diseases; Cushing Syndrome; Humans; Ketoconazole; Metyrapone; Mitotane; Pituitary ACTH

2020
Advances in the Medical Treatment of Cushing Disease.
    Endocrinology and metabolism clinics of North America, 2020, Volume: 49, Issue:3

    Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Cabergoline; Endocrinology; Humans; Mifepristone; Mitotan

2020
Efficacy of medical treatment in Cushing's disease: a systematic review.
    Clinical endocrinology, 2014, Volume: 80, Issue:1

    Topics: Cabergoline; Ergolines; Female; Humans; Ketoconazole; Male; Metyrapone; Mitotane; Pituitary ACTH Hyp

2014
Cushing's disease: current medical therapies and molecular insights guiding future therapies.
    Neurosurgical focus, 2015, Volume: 38, Issue:2

    Topics: Clinical Trials as Topic; Drug Delivery Systems; Female; Forecasting; Humans; Male; Mitotane; Pituit

2015
Medical therapy of Cushing's disease: where are we now?
    Frontiers of hormone research, 2010, Volume: 38

    Topics: Dopamine Agonists; Humans; Hydrocortisone; Ketoconazole; Metyrapone; Mifepristone; Mitotane; Pituita

2010
New prospects for drug treatment in Cushing disease.
    Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion, 2012, Volume: 59, Issue:10

    Topics: Adenoma; Adrenocorticotropic Hormone; Animals; Cabergoline; Clinical Trials as Topic; Clinical Trial

2012
Medical treatment of Cushing's disease.
    The Journal of clinical endocrinology and metabolism, 2013, Volume: 98, Issue:2

    Topics: Antineoplastic Agents, Hormonal; Dopamine Agonists; Humans; Mitotane; Octreotide; Pituitary ACTH Hyp

2013

Other Studies

6 other studies available for mitotane and Pituitary ACTH Hypersecretion

ArticleYear
Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism.
    Journal of veterinary internal medicine, 2023, Volume: 37, Issue:2

    Topics: Animals; Cushing Syndrome; Dog Diseases; Dogs; Mitotane; Muscles; Pituitary ACTH Hypersecretion

2023
Mitotane reduces human and mouse ACTH-secreting pituitary cell viability and function.
    The Journal of endocrinology, 2013, Volume: 218, Issue:3

    Topics: ACTH-Secreting Pituitary Adenoma; Adrenocorticotropic Hormone; Animals; Cell Line; Cell Survival; Co

2013
Treatment patterns in Cushing's disease patients in two large United States nationwide databases: application of a novel, graphical methodology.
    Pituitary, 2015, Volume: 18, Issue:4

    Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Adrenalectomy; Adult; Antineoplastic Agents, Hormonal; Co

2015
Ovarian macrocysts and gonadotrope-ovarian axis disruption in premenopausal women receiving mitotane for adrenocortical carcinoma or Cushing's disease.
    European journal of endocrinology, 2015, Volume: 172, Issue:2

    Topics: Adolescent; Adrenocortical Carcinoma; Adult; Antineoplastic Agents, Hormonal; Biomarkers; Female; Go

2015
Successful therapy of Cushing's disease caused by an extrapituitary parasellar adenoma.
    Clinical endocrinology, 2010, Volume: 73, Issue:1

    Topics: Adenoma; Aged; Female; Humans; Magnetic Resonance Imaging; Mitotane; Pituitary ACTH Hypersecretion;

2010
Efficiency and tolerance of mitotane in Cushing's disease in 76 patients from a single center.
    European journal of endocrinology, 2012, Volume: 167, Issue:4

    Topics: Adolescent; Adult; Aged; Antineoplastic Agents, Hormonal; Cohort Studies; Female; Hormone Antagonist

2012