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2016 ; 19
(2
): 138-48
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English Wikipedia
Osilodrostat, a potent oral 11?-hydroxylase inhibitor: 22-week, prospective,
Phase II study in Cushing s disease
#MMPMID26542280
Fleseriu M
; Pivonello R
; Young J
; Hamrahian AH
; Molitch ME
; Shimizu C
; Tanaka T
; Shimatsu A
; White T
; Hilliard A
; Tian C
; Sauter N
; Biller BM
; Bertagna X
Pituitary
2016[Apr]; 19
(2
): 138-48
PMID26542280
show ga
PURPOSE: In a 10-week proof-of-concept study (LINC 1), the potent oral
11?-hydroxylase inhibitor osilodrostat (LCI699) normalized urinary free cortisol
(UFC) in 11/12 patients with Cushing's disease. The current 22-week study (LINC
2; NCT01331239) further evaluated osilodrostat in patients with Cushing's
disease. METHODS: Phase II, open-label, prospective study of two patient cohorts.
Follow-up cohort: 4/12 patients previously enrolled in LINC 1, offered
re-enrollment if baseline mean UFC was above ULN. Expansion cohort: 15 newly
enrolled patients with baseline UFC > 1.5 × ULN. In the follow-up cohort,
patients initiated osilodrostat twice daily at the penultimate
efficacious/tolerable dose in LINC 1; dose was adjusted as needed. In the
expansion cohort, osilodrostat was initiated at 4 mg/day (10 mg/day if baseline
UFC > 3 × ULN), with dose escalated every 2 weeks to 10, 20, 40, and 60 mg/day
until UFC ? ULN. Main efficacy endpoint was the proportion of responders (UFC ?
ULN or ?50% decrease from baseline) at weeks 10 and 22. RESULTS: Overall response
rate was 89.5% (n/N = 17/19) at 10 weeks and 78.9% (n/N = 15/19) at 22 weeks; at
week 22, all responding patients had UFC ? ULN. The most common AEs observed
during osilodrostat treatment were nausea, diarrhea, asthenia, and adrenal
insufficiency (n = 6 for each). New or worsening hirsutism (n = 2) and/or acne (n
= 3) were reported among four female patients, all of whom had increased
testosterone levels. CONCLUSIONS: Osilodrostat treatment reduced UFC in all
patients; 78.9% (n/N = 15/19) had normal UFC at week 22. Treatment with
osilodrostat was generally well tolerated.