E-news: Effectiveness of metyrapone in patients with Cushing's syndrome

A large study confirms the efficacy and safety of metyrapone but also suggests a need for higher doses and frequent monitoring.  

Metyrapone is widely used in the UK for the control of cortisol excess in Cushing's syndrome, but its use is not standardised. There are a few reports published on metyrapone use, mostly containing small patient numbers.

Eleni Daniel et al conducted a retrospective survey across 13 tertiary centres. Using a standardised proforma, extensive data including monitoring and safety information were collected for patients with Cushing's syndrome on metyrapone therapy between 1997 and 2013.

Metyrapone was effective in achieving eucortisolaemia in over 80% of patients, with a satisfactory safety profile. A variety of monitoring regimens were used, but greater standardisation of practice and more active dose titration is needed.

This is the largest report of metyrapone use.