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Msg  2725 of 2910  at  8/6/2019 10:53:14 AM  by

BSR_Alan

The following message was updated on 8/6/2019 10:59:15 AM.

 In response to msg 2724 by  i760
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Re: Question on expansion trial for cushings

  
 i760 saith:  I missed that small (8 subject) trial with Kormlyn.
https://clinicaltrials.gov/ct2/show/NCT01990560
 
Interesting that the trial defined "mild" based on small elevation in cortisol along with a benign adrenal tumor (on imaging) and having concurrent evidence of diabetes or abnormal glucose tolerance. For Relacorliant I would guess they add glucose and/or elevated BP.
 
Hi i760, feel free to check it out at: 
 
 
The early results on 8 AI (less severe) people show an advantage with insulin resistance. This is the real game...as sometimes glucose levels and insulin response diverge quite a bit (e.g. eat Spam and your glucose stays the same, but your IR goes up).
 
Then Miguel Debono and his colleagues at the University of Sheffield had almost mirror results on 6 AI patients.
 
and a recent article on 4 patients. 
 
...I can keep pointing to smaller studies, and it's a consistent picture. And why not? It's indeed a variant of Cushing's.
 
This really takes the wind out any drug that has a darker side effect profile. Can we really see many physicians prescribing ketoconazole or its variants to less severe patients? Nope.
 
As for the market size, there are clues although no conclusive evidence that it's larger than "severe Cushing's". With orphan diseases, the less severe forms are typically much more prevalent. Furthermore "less severe Cushing's" will be increasingly detected as our scanning technologies continually get better cheaper and faster.  
 


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Msg # Subject Author Recs Date Posted
2726 Re: Question on expansion trial for cushings i760 5 8/6/2019 12:40:10 PM






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