EFFECTS OF THE USE OF PHARMACOLOGICAL THERAPIES IN THE CONTROL OF HYPERCORTISOLISM

Authors

  • Gabriella Corrêa Leite Unicesumar, Maringá- PR
  • Lorena Martins Dator Unicesumar, Maringá-PR
  • Beatriz Avila Romero Batista Unicesumar, Maringá-PR
  • Ana Carolina Mesquita Petruco Unicesumar, Maringá-PR
  • Caroline Pagnoncelli Corrêa Unicesumar, Maringá-PR
  • Gabriela Rie Kobayashi
  • Camila Ruzza de Oliveira União das Faculdades dos Grandes Lagos, São José do Rio Preto- SP
  • Fabiana Rodrigues Silva Gasparin Unicesumar, Maringá-PR

DOI:

https://doi.org/10.36557/2674-8169.2025v7n7p1739-1754

Keywords:

Hypercortisolism, Cushing’s Syndrome, Drug Therapy, Mifepristone, Metyrapone, Ketoconazole

Abstract

Hypercortisolism, known as Cushing's syndrome (CS), is characterized by chronic excess cortisol, causing multiple systemic changes. Although surgery is the treatment of choice, many patients do not achieve remission, necessitating a pharmacological approach. The objective of this study was to review the effects and mechanisms of action of the main drugs used to control hypercortisolism: mifepristone, metyrapone, and ketoconazole/levoketoconazole. This is a systematic literature review, searching PubMed, SciELO, and BVS databases between 2005 and 2025. Clinical studies and reviews addressing CS patients treated with the aforementioned drugs were included. The articles were selected using the Rayyan platform. Fifteen studies were analyzed. Ketoconazole was shown to be effective in reducing urinary cortisol in up to 85% of patients. Mifepristone demonstrated clinical improvement, particularly in glycemic control and weight loss, even without a reduction in cortisol levels. Metyrapone inhibited cortisol production, with positive results. Levoketoconazole, in addition to controlling cortisol, also showed cardiovascular benefits. The conclusion is that the medications evaluated are effective options for controlling hypercortisolism, especially in cases of surgical failure or contraindication. The choice of treatment should consider the clinical profile and individual response of each patient.

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References

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Published

2025-07-31

How to Cite

Leite, G. C., Dator, L. M., Batista, B. A. R., Petruco, A. C. M., Corrêa, C. P., Kobayashi, G. R., Oliveira, C. R. de, & Gasparin, F. R. S. (2025). EFFECTS OF THE USE OF PHARMACOLOGICAL THERAPIES IN THE CONTROL OF HYPERCORTISOLISM. Brazilian Journal of Implantology and Health Sciences, 7(7), 1739–1754. https://doi.org/10.36557/2674-8169.2025v7n7p1739-1754

Issue

Vol. 7 No. 7 (2025): BJIHS QUALIS B3 - FATOR DE IMPACTO SJIF 5.807 - ÍNDICE H 22

Section

Systematic Review

License

Copyright (c) 2025 Gabriella Corrêa Leite, Lorena Martins Dator, Beatriz Avila Romero Batista, Ana Carolina Mesquita Petruco, Caroline Pagnoncelli Corrêa, Gabriela Rie Kobayashi, Camila Ruzza de Oliveira, Fabiana Rodrigues Silva Gasparin

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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