EXPERIENCE WITH TRILOSTANE IN THE TREATMENT OF CUSHING'S SYNDROME

Abstract
Five patients with pituitary dependent Cushing''s syndrome and 2 with adrenal carcinoma were treated with increasing doses of trilostane (up to 1440 mg daily). There was no consistent fall in serum cortisol levels. In addition there was no rise in the levels of precursors immediately preceding the proposed site of action of trilostane. Apparently, trilostane does not effectively block the enzyme 3.beta.-hydroxysteroid dehydrogenase .DELTA.4,.DELTA.5 isomerase in patients with Cushing''s syndrome and it should no longer be recommended for their treatment.