Relacorilant or surgery improved hemostatic markers in Cushing syndrome

Area of Science:

• Endocrinology
• Hematology
• Pharmacology

Background:

• Cushing syndrome (CS) is associated with glucocorticoid excess, leading to hypercoagulability.
• This hypercoagulability can persist post-surgery, potentially increasing thrombotic risks.
• Characterizing coagulation changes is crucial for managing CS patients.

Purpose of the Study:

• To assess coagulation markers in patients with endogenous CS.
• To evaluate the impact of relacorilant treatment on coagulation.
• To examine coagulation changes following surgical remission in CS patients.

Main Methods:

• An open-label, phase 2 study (NCT02804750) assessed 34 patients receiving relacorilant.
• Coagulation markers were measured pre- and post-treatment in the relacorilant study.
• A retrospective study evaluated 30 CS patients before and after surgical remission at "Federico II" University.

Main Results:

• Relacorilant treatment led to significant reductions in factor VIII and platelet count, and a prolongation of aPTT.
• Post-surgical remission showed significant decreases in factor VIII and von Willebrand factor, and a prolongation of aPTT.
• Von Willebrand factor remained unchanged with relacorilant; platelet count was unchanged post-surgery.

Conclusions:

• Relacorilant treatment and surgical remission positively impact key coagulation markers in CS patients.
• These improvements suggest relacorilant's potential therapeutic role, particularly preoperatively or for non-surgical candidates.
• Further research is warranted to explore relacorilant's preoperative use in CS management.