Table 1.

Risk of bias of the included studies.

Author	Year	1. Clear inclusion criteria	2. Diagnostic criteria stated	3. Valid biochemical assay to measure hypercortisolism	4. Consecutive and complete inclusion of participants	5. Complete reporting of baseline information	6. Complete reporting of outcomes	7. Complete reporting of site demographics	8. Appropriate statistical analysis	Overall risk of biasa
Barbot et al. (60)	2014	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Colao et al. (10)	2012	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Lacroix et al. (54)	2018	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Albani et al. (55)	2018	✅	✅	✅	⚠	❌	✅	✅	✅	High risk
Barbot et al. (11)	2018	✅	✅	✅	✅	❌	✅	✅	❌	Some concerns
Boscaro et al. (56)	2014	✅	✅	✅	⚠	✅	✅	✅	✅	Some concerns
Fleseriu et al. (57) (pasireotide)	2018	✅	✅	✅	⚠	✅	❌	✅	✅	High risk
Pivonello et al. (58)	2019	✅	✅	✅	⚠	✅	✅	✅	✅	Some concerns
Vilar et al. (61)	2010	✅	✅	✅	⚠	✅	❌	✅	✅	High risk
Lila et al. (62)	2010	✅	✅	❌	⚠	✅	❌	✅	✅	High risk
Pivonello et al. (12)	2009	✅	✅	✅	⚠	✅	✅	✅	✅	Some concerns
Castinetti et al. (72)	2008	✅	✅	⚠	✅	❌	❌	✅	❌	High risk
Castinetti et al. (71)	2014	✅	✅	⚠	⚠	✅	✅	✅	✅	Some concerns
Invitti et al. (70)	1999	✅	✅	✅	⚠	❌	❌	✅	❌	High risk
Valassi et al. (69)	2012	✅	✅	✅	⚠	❌	❌	✅	❌	High risk
Godbout et al. (63)	2010	✅	✅		⚠	✅	✅	✅	✅	Some concerns
Ferriere (64)	2016	✅	✅		⚠	✅	✅	✅	✅	Some concerns
Trementino et al. (59)	2016	✅	✅	✅	✅	❌	❌	✅		High risk
Luisetto et al. (68)	2001	✅	✅			✅	❌	✅		High risk
Ghervan et al. (67)	2015	✅	✅	✅		✅	❌	✅		High risk
Ceccato et al. (75)	2018	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Pivonello et al. (77)	2020	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Van der Bosch et al. (66)	2014	✅	✅	✅		✅	❌	✅		High risk
Moncet et al. (73)	2007	✅	✅		❌	❌	❌	✅		High risk
Sonino et al. (65)	1991	✅	✅	✅	✅	✅	✅	✅	✅	Low risk
Verhelst et al. (74)	1991	✅	✅	❌		✅	❌	✅		High risk

❌, high risk of bias; ✅, low risk of bias; , unclear.

^aFor overall risk of bias, criteria 4, 5, and 6 were taken into consideration. Overall risk of bias was low if all three were low risk. If one of the three criteria were unclear or high risk, the overall assessment was “some concerns”; if two were unclear or high risk, the overall assessment was “high risk”.