Table 2.
Effects of steroidogenesis inhibitors on corticotropinomas’ volume.
| Drug | Mechanism of Action | Study Design | Duration | Effect on Tumor Volume | Cases | Study |
|---|---|---|---|---|---|---|
| Ketoconazole | Side-chain cleavage 17, 20 lyase 11β-hydroxylase Aldosterone synthase |
Retrospective | na | Visualization of the adenoma after a previously negative MRI | 8/58 * | Castinetti F, 2014 [84] |
| Mitotane | Side-chain cleavage 11β-hydroxylase |
Retrospective | 10, 9 months ** | Visualization of the adenoma after a previously negative MRI | 12/48 * | Baudry C, 2012 [85] |
| Metyrapone | 11β-hydroxylase Aldosterone synthase |
Case report | 2 months | Tumor shrinkage | 1 | Tsujimoto Y, 2021 [83] |
| Osilodrostat | 11β-hydroxylase Aldosterone synthase |
Prospective | 48 weeks | Tumor volume decrease ≥20% | 24/64 | Pivonello R, 2020 [86] |
| Tumor volume increase ≥20% | 21/64 | |||||
| Case report | 4 years ** | Late onset tumor increase | 1 | Fontaine-Sylvestre C, 2021 [87] |
* Proportion of patients with baseline negative MRI presenting newly visible adenoma; ** mean time to effect; na = not assessed, MRI = Magnetic resonance imaging.