Evidence of Persistent Mild Hypercortisolism in Patients Medically Treated for Cushing Disease: the Haircush Study
Authors' conclusion
Despite normalized UFCs, a subset of medically treated CD patients displays an altered circadian rhythm of serum cortisol. A single HE measurement identifies chronic mild persistent hypercortisolism and could replace multiple saliva analyzes to monitor medical treatments in CD patients once UFC is normalized.
Study context
- Population
- Female patients with Cushing disease (CD)
- Participants
- 16 / 13 / 15
- Exposure
- Medically treated CD vs surgically cured CD vs bilateral adrenalectomy on hydrocortisone
- CushMedn = 16
- CushSurgn = 13reference
- CushBlan = 15
- Outcome
- Main outcome measures: clinical score, centralized UFC, late-night salivary cortisol (LNSF), late-night salivary cortisone (LNSE), hair cortisone (HE), hair cortisol (HF)
- Follow-up
- 3 months
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
- CushBla had increased HF and HE, with LNSE similar to CushSurg
- CushMed vs CushSurg: P = 0.003
- CushMed vs CushSurg: P = 0.001
- CushMed vs CushSurg: P = 0.03
- CushMed vs CushSurg: P = 0.0001
- CushMed vs CushSurg: P = 0.004
- Almost all Urinary Free Cortisol (UFCs) normalized in CushMed
Observational data: associations, not effects.
Further findings
- CushMed with increased HE vs normal HE: antihypertensive drug dosage — CushMed with increased HE · higher antihypertensive dosage with increased HE
- 6 of 15 · P = 0.05
Original publication
Evidence of Persistent Mild Hypercortisolism in Patients Medically Treated for Cushing Disease: the Haircush Study. J Clin Endocrinol Metab. Published 5 May 2023. doi:10.
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