Clinical Practice Guideline

Treatment of Cushing's Syndrome Guideline Resources

August 19, 2015

Full Guideline: Treatment of Cushing's Syndrome
JCEM | August 2015

Lynnette K. Nieman (chair), Beverly M. K. Biller, James W. Findling, M. Hassan Murad, John Newell-Price, Martin O. Savage, and Antoine Tabarin

The 2015 guideline addresses:

  • Picking the optimal treatment to address the underlying cause (e.g., tumor removal)
  • Adjuctive management and treatment of cortisol-dependent comorbidities
  • Approaching second-line therapeutic options


Treatment of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline | ENDO 2015



Essential Points

The Endocrine Society recommends that the first-line treatment for endogenous Cushing’s syndrome be the removal of the tumor unless surgery is not possible or unlikely to address the excess cortisol. Surgical removal of the tumor is optimal because it leaves intact the hypothalamic-pituitary-adrenal axis, which is integral to the body’s central stress response.

Summary of Recommendations

+ 1.0 Treatment goals for Cushing’s syndrome

+ 2.0 Optimal adjunctive management

+ 3.0 First-line treatment options

+ 4.0 Remission and recurrence after surgical tumor resection

+ 5.0 Glucocorticoid replacement and discontinuation, and resolution of other hormonal deficiencies

+ 6.0 Second-line therapeutic options

6.2 Repeat transsphenoidal surgery

6.3 Radiation therapy/radiosurgery for CD

6.4 Medical treatment

+ 7.0 Approach for long-term follow-up

+ 8.0 Special populations/considerations

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Practical quick-reference tools to help you make accurate clinical decisions at the point of care.

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