Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline
Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline
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DOI：
10.1210/jc.2015-1818
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发表时间：
2015-08-01
影响因子：
5.8
通讯作者：
Tabarin, Antoine
中科院分区：
文献类型：
--
作者：
Nieman, Lynnette K.;Biller, Beverly M. K.;Tabarin, Antoine
目的：目的是制定临床实践指南治疗库欣综合征。参与者：参与者包括内分泌学会指定的专家工作组，一个方法学家，和一个医学作家。欧洲内分泌学会共同发起了该指南。证据：工作组使用推荐分级、评估、开发和评价系统来描述推荐的强度和证据的质量。工作组委托三个系统评价，并使用最好的证据，从其他已发表的系统评价和个别study.Consensus过程：工作组取得了共识，通过一个小组会议，几个电话会议，和众多的电子邮件通信。委员会和成员的内分泌学会和欧洲内分泌学会审查和评论这些guidelines.Conclusions的初稿：治疗库欣综合征是必不可少的，以减少死亡率和相关的合并症。有效的治疗包括皮质醇水平或行动的正常化。它还包括通过直接治疗库欣综合征的病因和连续治疗（如抗高血压药）使合并症正常化。手术切除致病病变通常是一线方法。二线治疗的选择，包括药物治疗、双侧肾上腺切除术和放射治疗（用于促肾上腺皮质激素肿瘤），必须根据每位患者的个体化情况而定。
Objective: The objective is to formulate clinical practice guidelines for treating Cushing's syndrome.Participants: Participants include an Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. The European Society for Endocrinology co-sponsored the guideline.Evidence: The Task Force used the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews and used the best available evidence from other published systematic reviews and individual studies.Consensus Process: The Task Force achieved consensus through one group meeting, several conference calls, and numerous e-mail communications. Committees and members of The Endocrine Society and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines.Conclusions: Treatment of Cushing's syndrome is essential to reduce mortality and associated comorbidities. Effective treatment includes the normalization of cortisol levels or action. It also includes the normalization of comorbidities via directly treating the cause of Cushing's syndrome and by adjunctive treatments (eg, antihypertensives). Surgical resection of the causal lesion(s) is generally the first-line approach. The choice of second-line treatments, including medication, bilateral adrenalectomy, and radiation therapy (for corticotrope tumors), must be individualized to each patient.