Cushing’s disease: the burden of illness
| Autor: | Rosario Pivonello, Monica De Leo, Annamaria Colao, Chiara Simeoli, Maria Cristina De Martino |
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| Přispěvatelé: | Pivonello, Rosario, DE MARTINO, MARIA CRISTINA, DE LEO, Monica, Simeoli, Chiara, Colao, Annamaria |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Quality of life
Pediatrics medicine.medical_specialty Hydrocortisone medicine.medical_treatment Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Disease 03 medical and health sciences 0302 clinical medicine Endocrinology Cost of Illness Diabetes mellitus medicine Humans Mortality Pituitary ACTH Hypersecretion business.industry Pituitary ACTH hypersecretion Adrenalectomy Cushing's disease Cushing’s disease medicine.disease Surgery Radiation therapy Treatment Outcome Pituitary Gland Morbidity business Psychosocial 030217 neurology & neurosurgery medicine.drug |
| Popis: | Cushing's syndrome is caused by prolonged exposure to elevated cortisol levels. The most common form of endogenous Cushing's syndrome is Cushing's disease, which results from an adrenocorticotropic hormone-secreting pituitary tumour. Cushing's disease is associated with increased mortality, mostly attributable to cardiovascular complications, and a host of comorbidities such as metabolic and skeletal disorders, infections and neuropsychiatric disturbances. As a consequence, Cushing's disease substantially impairs health-related quality of life. It is crucial that the condition is diagnosed as early as possible, and that rapid and effective treatment is initiated in order to limit long-term morbidity and mortality. The initial treatment of choice for Cushing's disease is selective transsphenoidal pituitary surgery; however, the risk of recurrence after initial surgery is high and remains so for many decades after surgery. A particular concern is the growing body of evidence indicating that the negative physical and psychosocial sequelae of chronic hypercortisolism may persist in patients with Cushing's disease even after long-term surgical 'cure'. Current treatment options for post-surgical patients with persistent or recurrent Cushing's disease include second surgery, radiotherapy, bilateral adrenalectomy and medical therapy; however, each approach has its limitations and there is an unmet need for more efficacious treatments. The current review provides an overview of the burden of illness of Cushing's disease, underscoring the need for prompt diagnosis and effective treatment, as well as highlighting the need for better therapies. |
| Databáze: | OpenAIRE |
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