Method for differentially diagnosing ACTH-dependent Cushing's syndrome
AssigneeCorcept Therapeutics, Inc.
InventorAndreas G. Moraitis
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Abstract
This invention provides for an improved method for differentially diagnosing ACTH-dependent Cushing's syndrome. Current practice for differentially diagnosing ectopic ACTH syndrome and Cushing's Disease measures relative ACTH concentrations from the inferior petrosal venous sinus compared to fluid obtained from a periphery venous sample. This is performed before and after administration of exogenous corticotropin releasing factor, or after administration of metyrapone. This invention uses glucocorticoid receptor antagonists to induce release of endogenous CRH which stimulates ACTH to increase in patients with ectopic ACTH syndrome but not in those with Cushing's Disease.
Claims17
A method of concurrently treating Cushing's syndrome and obtaining a measurement indicative of differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome in a patient where the differential diagnosis is between ectopic ACTH syndrome and Cushing's disease, the method comprising the steps of:
- administering a dose of glucocorticoid receptor antagonist (GRA) to a patient with Cushing's syndrome and an elevated ACTH level, wherein the amount of GRA administered to said patient is sufficient to increase ACTH from the pituitary gland by at least two-fold in persons with normal Hypothalamus Pituitary Adrenal (HPA) function;
- then,
- determining the ACTH concentration ratio from venous samples obtained from the patient at least two hours following said administration, wherein said venous samples are obtained from a) both the left and the right inferior petrosal venous sinus and from b) a peripheral vein;
- and
- wherein an ACTH concentration ratio of greater than 3 for the ACTH concentration from an inferior petrosal venous sinus sample over the peripheral venous sample is diagnostic of Cushing's disease.
Dependencies are inferred from the claim text.