Imperial College London
Alternate

Professor Karim Meeran

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

+44 (0)20 8846 1065k.meeran

 
 
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Location

 

9E05Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Daniel:2015:10.1210/jc.2015-2616,
author = {Daniel, E and Aylwin, S and Mustafa, O and Ball, S and Munir, A and Boelaert, K and Chortis, V and Cuthbertson, DJ and Daousi, C and Rajeev, SP and Davis, J and Cheer, K and Drake, W and Gunganah, K and Grossman, A and Gurnell, M and Powlson, AS and Karavitaki, N and Huguet, I and Kearney, T and Mohit, K and Meeran, K and Hill, N and Rees, A and Lansdown, AJ and Trainer, PJ and Minder, A-EH and Newell-Price, J},
doi = {10.1210/jc.2015-2616},
journal = {J Clin Endocrinol Metab},
pages = {4146--4154},
title = {Effectiveness of Metyrapone in Treating Cushing's Syndrome: A Retrospective Multicenter Study in 195 Patients.},
url = {http://dx.doi.org/10.1210/jc.2015-2616},
volume = {100},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Cushing's syndrome (CS) is a severe condition with excess mortality and significant morbidity necessitating control of hypercortisolemia. There are few data documenting use of the steroidogenesis inhibitor metyrapone for this purpose. OBJECTIVE: The objective was to assess the effectiveness of metyrapone in controlling cortisol excess in a contemporary series of patients with CS. DESIGN: This was designed as a retrospective, multicenter study. SETTING: Thirteen University hospitals were studied. PATIENTS: We studied a total of 195 patients with proven CS: 115 Cushing's disease, 37 ectopic ACTH syndrome, 43 ACTH-independent disease (adrenocortical carcinoma 10, adrenal adenoma 30, and ACTH-independent adrenal hyperplasia 3). MEASUREMENTS: Measurements included biochemical parameters of activity of CS: mean serum cortisol "day-curve" (CDC) (target 150-300 nmol/L); 9 am serum cortisol; 24-hour urinary free cortisol (UFC). RESULTS: A total of 164/195 received metyrapone monotherapy. Mean age was 49.6 ± 15.7 years; mean duration of therapy 8 months (median 3 mo, range 3 d to 11.6 y). There were significant improvements on metyrapone, first evaluation to last review: CDC (91 patients, 722.9 nmol/L [26.2 μg/dL] vs 348.6 nmol/L [12.6 μg/dL]; P < .0001); 9 am cortisol (123 patients, 882.9 nmol/L [32.0 μg/dL] vs 491.1 nmol/L [17.8 μg/dL]; P < .0001); and UFC (37 patients, 1483 nmol/24 h [537 μg/24 h] vs 452.6 nmol/24 h [164 μg/24 h]; P = .003). Overall, control at last review: 55%, 43%, 46%, and 76% of patients who had CDCs, UFCs, 9 am cortisol less than 331 nmol/L (12.0 μg/dL), and 9 am cortisol less than upper limit of normal/600 nmol/L (21.7 μg/dL). Median final dose: Cushing's disease 1375 mg; ectopic ACTH syndrome 1500 mg; benign adrenal disease 750 mg; and adrenocortical carcinoma 1250 mg. Adverse events occurred in 25% of patients, mostly mild gastrointestinal upset and dizziness, usually within 2 weeks of init
AU  - Daniel,E
AU  - Aylwin,S
AU  - Mustafa,O
AU  - Ball,S
AU  - Munir,A
AU  - Boelaert,K
AU  - Chortis,V
AU  - Cuthbertson,DJ
AU  - Daousi,C
AU  - Rajeev,SP
AU  - Davis,J
AU  - Cheer,K
AU  - Drake,W
AU  - Gunganah,K
AU  - Grossman,A
AU  - Gurnell,M
AU  - Powlson,AS
AU  - Karavitaki,N
AU  - Huguet,I
AU  - Kearney,T
AU  - Mohit,K
AU  - Meeran,K
AU  - Hill,N
AU  - Rees,A
AU  - Lansdown,AJ
AU  - Trainer,PJ
AU  - Minder,A-EH
AU  - Newell-Price,J
DO  - 10.1210/jc.2015-2616
EP  - 4154
PY  - 2015///
SP  - 4146
TI  - Effectiveness of Metyrapone in Treating Cushing's Syndrome: A Retrospective Multicenter Study in 195 Patients.
T2  - J Clin Endocrinol Metab
UR  - http://dx.doi.org/10.1210/jc.2015-2616
UR  - https://www.ncbi.nlm.nih.gov/pubmed/26353009
VL  - 100
ER  -
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