Table 2.
Individual data.
| ID | Sex | Time(months) | Prior TSS | Prior RDT | Dose variation (mg) a | Daily doses | Baseline ACTH | Baseline X > ULNUFC | Final X > ULNUFC | Final therapeutic response | Comorbidities | Altered liver function | Regular use | Intolerance/adverse effects | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | F | 42 | Yes | No | 400–600 | 3 | 41 | 0.13 | 0.4b | Complete | SAH and DM | No | Yes | No | Continued use | |
| 2 | F | 7 | Yes | Yes | 100–200 | 2 | 88 | 1 | 0.79b | Complete | SAH | No | Yes | Yes, nausea | Interrupted due to intolerance | |
| 3 | F | 5 | No, pre-TSS use | No | 200–400 | 2 | 5.4 | 0.39 | Partial | SAH | Yes—drug hepatitis | Yes | Yes, hepatitis | Interrupted due to drug hepatitis | ||
| 4 | F | 120 | No | No | 200–800 | 4 | 76 | 2.92 | 0.8b | Complete | – | No | Yes | Yes | Pseudotumor cerebri resolved with acetazolamide | |
| 5 | F | 126 | Yes | No | 150–1,000 | 4 to 5 | 129 | 0.05 | -0.36 | Complete | Dyslipidemia | No | Yes | No | Continued use | |
| 6 | F | 90 | Yes | No | 300–1,000 | 4 to 5 | 26 | 3.9 | -0.7 | Complete | SAH and DM | No | Yes | No | Underwent radiotherapy | |
| 7 | F | 63 | Yes | No | 400–1,000 | 3 | 148 | 5.8 | -0.46 | Complete | SAH | No | Yes | No | Underwent radiotherapy | |
| 8 | F | 26 | No, pre-TSS use | No | 600–800 | 4 | 106 | 2.56 | 0.39b | No response | SAH and DM | No | Yes | No | Underwent TSS | |
| 9 | F | 81 | Yes | No | 600–1,200 | 5 | 24 | 22.2 | 5.68b | No response | SAH | No | Yes | Yes | Underwent bilateral adrenalectomy | |
| 10 | F | 86 | Yes | No | 400–1,200 | 4 to 5 | 65 | 0.72 | -0.47 | Complete | – | Important and isolated elevation of GGT | Yes | No | Underwent new TSS | |
| 11 | F | 51 | Yes | No | 400–800 | 2 | 48 | -0.68 b | -0.8 | Complete | SAH and dyslipidemia | Discrete and isolated elevation of GGT | Yes | No | Continued use | |
| 12 | F | 14 days | No | No | 600 | 3 | 121 | 4.3 | 3.5 | No response | SAH and DM | No | Yes | No | Underwent TSS | |
| 13 | F | 15 | Yes | No | 600–800 | 4 | 50 | 0.1 | -0.06 | Complete | SAH, DM and dyslipidemia | Discrete and isolated elevation of GGT | No | No | Continued use | |
| 14 | F | 85 | Yes | No | 200–800 | 4 | 37 | 2.11 | -0.38b | No response | SAH | Elevation of TGO and GPT, discontinued medication | Yes | Yes | Underwent radiotherapy | |
| 15 | F | 119 | Yes | No | 600–1,200 | 4 to 5 | 40 | 2.31 | 1.3 | Partial | SAH, DM and dyslipidemia | Discrete and isolated elevation of GGT | Yes | No | Underwent radiotherapy | |
| 16 | F | 14 | Yes | Yes | 600 | 3 | 300 | 0.27 | -0.06b | Partial | SAH and dyslipidemia | No | Yes | No | Underwent bilateral adrenalectomy | |
| 17 | M | 29 | Yes | No | 400–600 | 3 | 54 | 1.62 | -0.6 | Complete | – | No | Yes | Yes, loss of appetite | Ketoconazole suspended due to loss of appetite | |
| 18 | F | 5 | Yes | No | 400 | 2 | 65 | - 0.08 b | -0.8 | Complete | SAH and DM | Discrete and isolated GGT uptake | Yes | No | Underwent radiosurgery | |
| 19 | M | 42 | No, pre-TSS use | No | 400–1,200 | 2 to 6 | 51 | 3.67 | 2.8 | No response | SAH | Discrete elevation of TGO and GGT | No | No | Underwent TSS | |
| 20 | F | 6 | Yes | No | 400 | 2 | 115 | 3.9 | 2b | No response | – | No | Yes | No | Lost to follow-up | |
| 21 | F | 125 | Yes | Yes | 400–1,000 | 3 to 5 | 84 | 1.34 | -0.02 | Complete | SAH | No | Yes | Yes, diarrhea | Underwent bilateral adrenalectomy | |
| 22 | M | 34 | Yes | Yes | 100 | 2 | 0.3 | -0.8 | Complete | SAH, DM and dyslipidemia | No | Yes | No | Lost to follow-up | ||
| 23 | F | 53 | Yes | No | 200–600 | 2 to 4 | 61 | 1.19 | -0.6 | Complete | SAH and DM | No | Yes | Yes, dizziness | Continued use | |
| 24 | M | 3 | Yes | No | 600 | 3 | 1,696 | 34 | 0.8b | Complete | SAH | No | Yes | No | Underwent bilateral adrenalectomy | |
| 25 | F | 133 | Yes | No | 400 | 2 | 89 | 0.4 | -0.8 | Complete | SAH | No | Yes | No | Continued use | |
| 26 | F | 23 | Yes | No | 200–800 | 2 to 4 | 57 | 0.53 | -0.08 | No response | – | No | Yes | No | Underwent radiosurgery | |
| 27 | F | 38 | No, pre-TSS use | No | 400–600 | 2 to 3 | 102 | 4.1 | -0.3 | Complete | SAH and DM | No | Yes | Yes, dizziness and loss of appetite | Continued use | |
| 28 | M | 111 | Yes | No | 400—1,200 | 3 to 4 | 75 | 3.9 | -0.8 | Complete | SAH | Discrete elevation of TGO, GPT, and GGT | Yes | Yes, nausea | Underwent radiotherapy | |
| 29 | F | 8 | No, pre-TSS use | No | 300 | 3 | 92 | 2.2 | 0.8b | No response | SAH | No | Yes | No | Underwent TSS | |
| 30 | F | 132 | Yes | No | 200–400 | 2 to 3 | 20 | -0.2 b | -0.5 | Complete | SAH, DM and dyslipidemia | No | Yes | No | Continued use | |
| 31 | F | 40 | Yes | No | 400–800 | 2 to 3 | 21 | 0.7 | -0.99 | Complete | SAH and DM | No | Yes | No | Continued use | |
| 32 | F | 64 | Yes | No | 400–800 | 2 to 4 | 41 | -0.7 b | -0.6 | Complete | – | Discrete and isolated elevation of GGT | Yes | No | Underwent radiotherapy | |
| 33 | F | 173 | Yes | Yes | 400–800 | 2 to 4 | 40 | 0.05 | -0.5 | Complete | SAH | No | No | No | Pregnancy continued using ketoconazole without complications | |
RDT, radiotherapy; DM, diabetes mellitus; GGT, gamma glutamyl transferase; SAH, systemic arterial hypertension; TGO, oxaloacetic transaminase; GPT, glutamate–pyruvate transaminase; TSS, transsphenoidal surgery; ULN, upper limit of normal.
The highest dose used was not necessarily the final dose used.
In these patients, the criterion used to consider active hypercortisolism was late night salivary cortisol and/or elevated 1 mg dexamethasone overnight.