Contemporary treatments for exogenous Cushing's syndrome: therapeutic advances and current clinical considerations
Keywords:
Exogenous Cushing syndrome, glucocorticoids, treatment, adverse effects, clinical managementAbstract
Exogenous Cushing syndrome remains a significant clinical challenge due to the widespread use of glucocorticoids and the complex metabolic, cardiovascular, and musculoskeletal manifestations associated with their excess. Current therapeutic approaches focus on reducing systemic exposure, optimizing dosing regimens, and incorporating immunomodulatory alternatives with improved safety profiles. Patient education, close monitoring, and early recognition of adverse effects have become essential to preventing complications and preserving quality of life. The development of new steroidogenesis-targeting agents and refined targeted therapies has broadened management options, particularly in cases where tapering glucocorticoids is insufficient or clinically difficult. Updated protocols for tapering regimens aim to support safe and gradual recovery of the hypothalamic–pituitary–adrenal axis. Multidisciplinary care, combining endocrinology, internal medicine, nutrition, and rehabilitation, is fundamental for addressing the multisystemic impact of this condition. Collectively, these advancements support a more individualized, preventive, and safety-oriented therapeutic model that balances pharmacological efficacy with long-term outcomes.
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