A Prospective Trial With Ketoconazole Induction Therapy and Octreotide Maintenance Treatment for Cushing's Disease.

Context And Objective: The lack of efficacy of somatostatin receptor subtype 2 (SST2) preferring somatostatin analogs in patients with Cushing's disease (CD) results from a downregulating effect of hypercortisolism on SST2 expression. Our objective is to evaluate the efficacy of a strategy with sequential treatment of ketoconazole to reduce cortisol levels and potentially restore SST2 expression followed by octreotide as maintenance therapy in patients with CD.

Patients And Design: Fourteen adult patients with CD were prospectively enrolled.