Diagnostic performance of desmopressin stimulation test in pediatric cushing’s disease
Authors' conclusion
Although the DDAVP stimulation test demonstrates lower diagnostic accuracy compared to the CRH test, it still provides sufficient sensitivity and given its availability and lower cost, it represents a pragmatic alternative to CRH stimulation.
Study context
- Population
- Pediatric patients with Cushing’s disease (CD) who underwent peripheral or bilateral inferior petrosal sinus sampling (BIPSS) stimulation testing with DDAVP or ovine corticotropin-releasing hormone (oCRH)matched 1:1
- Exposure
- DDAVP stimulation test vs oCRH stimulation test
- Outcome
- Test sensitivities based on ACTH and cortisol responses
Methodological detailsmatched 1:1 for age, sex, and tumor size
- Matched 1:1 for age, sex, and tumor size
Main finding
As reported in the abstract
Sensitivity, peripheral stimulation testing
| Group | Sensitivity for cortisol | Sensitivity for ACTH |
|---|---|---|
| DDAVP | 96.9% | 81.3% |
| oCRH | 93.8% | 96.9% |
Sensitivity for cortisol
DDAVP96.9%
oCRH93.8%
Sensitivity for ACTH
DDAVP81.3%
oCRH96.9%
- DDAVP vs oCRH: P > 0.05
Observational data: associations, not effects.
Further findings
Sensitivity, BIPSS
Sensitivity, baseline
Sensitivity, post-stimulation
Percentage change of ACTH, peripheral testing
- Percentage change of ACTH higher with CRH than DDAVP
Central-to-peripheral ACTH ratios, BIPSS
- Central-to-peripheral ACTH ratios similar across groups
Safety
- No major adverse events reported; both tests well tolerated
Original publication
Diagnostic performance of desmopressin stimulation test in pediatric cushing’s disease. Pituitary. Published 20 December 2025. doi:10.
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