Emerging Clinical Evidence and Cardiometabolic Outcomes in Hypercortisolism

In ‘Emerging Clinical Evidence and Cardiometabolic Outcomes in Hypercortisolism,’ our panel explores recent clinical data evaluating the impact of available therapies on cortisol control, metabolic health, and long-term disease management. The expert faculty discuss findings from clinical trials and real-world studies that continue to shape treatment decisions in patients with hypercortisolism.

The panelists begin by examining evidence for pasireotide in Cushing disease, highlighting its role as the only FDA-approved pituitary-directed therapy. They review clinical and real-world data demonstrating its ability to reduce cortisol excess while also addressing the important challenge of treatment-associated hyperglycemia. The discussion focuses on the mechanisms underlying these glycemic effects and the need for individualized management strategies when treating patients with existing metabolic risk factors.

The panel of experts then turns to data from the LINC clinical trial program evaluating osilodrostat. Faculty members discuss improvements in blood pressure, glycemic control, and overall cardiometabolic outcomes observed with treatment, emphasizing the potential for reducing medication burden while addressing the underlying pathophysiology of hypercortisolism. They also review recent evidence supporting the broader use of osilodrostat following expansion of its indication from Cushing disease to Cushing syndrome.

Throughout the conversation, the panel explores practical considerations associated with the use of potent cortisol synthesis inhibitors, including treatment titration, monitoring, and the management of adrenal insufficiency and glucocorticoid withdrawal symptoms. They discuss strategies for balancing efficacy with safety while maintaining long-term cortisol control. By reviewing emerging evidence and clinical experience, the faculty provide insight into how evolving data may influence therapeutic decision-making and improve cardiometabolic outcomes for patients with hypercortisolism.

Our next episode, ‘Evaluating Clinical and Real-World Evidence in Hypercortisolism,’ examines clinical trial data, real-world treatment experience, and emerging research that are shaping contemporary management of hypercortisolism. The panelists discuss evidence for levoketoconazole and mifepristone while exploring new insights into the relationship between cortisol excess, incretin biology, and metabolic dysfunction.