Clinical treatment guidelines

In 2015, the Endocrine Society produced a comprehensive set of guidelines for the treatment of CS (Nieman et al., 2015). The guidelines were co-sponsored by the European Society of Endocrinology and participants included an Endocrine Society-appointed Task Force of experts from France, the UK and the US. The Task Force assessed the quality of the available evidence, resulting in consensus on best practice for the treatment of CS.

The guidelines committee advised that:

The goals of treating CS are to eliminate its primary cause and achieve remission so as to eliminate the associated signs, symptoms, and comorbidities and to improve quality of life (QOL) (Nieman et al., 2015).


Figure 6. An algorithm for the treatment of Cushing's Syndrome.

Figure 6. An algorithm for the treatment of Cushing's Syndrome. Adapted from Nieman et al., 2015.
Adx: Adrenalectomy; CD: Cushing’s Disease; EAS: Ectopic ACTH Syndrome; GC: Glucocorticoid; IPSS: Inferior petrosal sinus sampling; RT: Radiotherapy; TSS: Transsphenoidal surgery.

Once a diagnosis of CS has been confirmed and the cause of CS has been established, the patient can be treated. However, the guidelines state that comorbidities should be treated first (Nieman et al., 2015).

You can access the guideline recommendations here.