2007
DOI: 10.1590/s0004-27302007000700014
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Effect of one month ketoconazole treatment on GH, cortisol and ACTH release after ghrelin, GHRP-6 and GHRH administration in patients with cushing’s disease

Abstract: GH responses to ghrelin, GHRP-6, and GHRH in Cushing's disease (CD) are markedly blunted. There is no data about the effect of reduction of cortisol levels with steroidogenesis inhibitors, like ketoconazole, on GH secretion in CD. ACTH levels during ketoconazole treatment are controversial. The aims of this study were to compare the GH response to ghrelin, GHRP-6, and GHRH, and the ACTH and cortisol responses to ghrelin and GHRP-6 before and after one month of ketoconazole treatment in 6 untreated patients wit… Show more

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Cited by 7 publications
(6 citation statements)
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References 47 publications
(90 reference statements)
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“…It has been previously shown that acute clinical interventions such as inhibition of free fatty acids and short-term dietary restriction (14,15) were able to increase GH secretion in CD. However, we did not observe significant changes in GH responses to ghrelin, GHRP-6, and GHRH after a short period (1 month) of ketoconazole use in patients with CD, although UFC values had a considerable fall (26).…”
Section: Discussioncontrasting
confidence: 79%
“…It has been previously shown that acute clinical interventions such as inhibition of free fatty acids and short-term dietary restriction (14,15) were able to increase GH secretion in CD. However, we did not observe significant changes in GH responses to ghrelin, GHRP-6, and GHRH after a short period (1 month) of ketoconazole use in patients with CD, although UFC values had a considerable fall (26).…”
Section: Discussioncontrasting
confidence: 79%
“…The modest rise in ACTH in patients with CD receiving levoketoconazole [57], and the preclinical findings of inhibitory effects on ACTH secretion and corticotroph cell growth [36], suggest the possibility of direct antisecretory effects on ACTH and/or a direct effect of tumor inhibition in the pituitary gland, similar to what has been reported with ketoconazole [42,62]. In addition, there is no evidence that short-or long-term treatment with ketoconazole has adverse effects on pituitary function in patients with CD or in healthy individuals or patients with other endocrine disorders [88][89][90][91][92][93][94][95].…”
Section: Place Of Levoketoconazole In the Treatment Algorithm For Cushing's Syndromementioning
confidence: 70%
“…6 Heterogeneous ACTH responses have been reported with ketoconazole use. [20][21][22][23][24]27 In short-term studies, a marked ACTH increase after CRH 23 and no changes in ACTH responsiveness to GHS 27 were observed, but higher doses of ketoconazole were used in the former study. In addition, no changes after CRH have been demonstrated after 3-13 months of ketoconazole use.…”
Section: Discussionmentioning
confidence: 99%
“…21,23 Unchanged ACTH responsiveness to CRH was observed after 3-13 months of ketoconazole use, 21 while a marked rise in ACTH responses after 4 to 6 weeks of treatment has also been demonstrated. 23 Recently, we have shown that GHS-stimulated ACTH levels do not change after 1 month of ketoconazole use in CD, 27 but these responses have not been studied after prolonged utilization of this compound.…”
Section: Introductionmentioning
confidence: 99%