Citations 1
Consensus on biomarker utility for ACTH-dependent Cushing syndrome: a Pituitary Society Modified Delphi Panel
Fleseriu, Maria , Biller, Beverly M. K. , Reincke, Martín , Мелмед, Шломо , Group, the Pituitary Society International Cushing Syndrome Delphi Panel Consensus, Akirov, Amit , Araki, Takako, Auchus, Richard, Ben-Shlomo, Anat , Bertherat, Jérôme, Biermasz, Nienke R, Castinetti, Frédéric, Ceccato, Filippo, Christ-Crain, Mirjam, Feelders, Richard A. , Findling, James W. , Gadelha, Monica, Geer, Eliza B, Giustina, Andrea, Grossman, Ashley, Gurnell, Mark, Hanzu, Felicia, Hinojosa-Amaya, Jose M, Isand, Kristina , Isidori, Andrea M, Kadioğlu, Pinar, Karavitaki, Niki, McCormack, A I, Nieman, Lynnette, Nowak, Elisabeth, Pivonello, Rosario, Salvatori, Roberto , Stewart, Paul M., Tabarin, Antoine, Takahashi, Yutaka, Theodoropoulou, Marily , Valassi, Elena, Varlamov, Elena V , Walia, Rama, Wass, John, Cheung, Cassandra, Priven, Mariel , Brown, Marielle, Biller, Beverly M K , Bancos, Irina , Fukuoka, Hidenori , Reincke, Martin , Newell-Price, John , Melmed, Shlomo , Bancos, Irina , Newell‐Price, John , Bertherat, Jérôme , Bidlingmaier, Martin , Biermasz, Nienke Ruurdje , Castinetti, Frédéric , Ceccato, Filippo , Christ‐Crain, Mirjam , Gadelha, Mônica R. , Geer, Eliza B. , Glezer, Andréa , Giustina, Andrea , Greenman, Yona , Grossman, Ashley, Gurnell, Mark , Hanzu, Felicia Alexandra , Hinojosa‐Amaya, José Miguel , Isidori, Andrea M. , Kadıoğlu, Pınar , Karavitaki, Niki , Langlois, Fabienne , Nieman, Lynnette K. , Nowak, Elisabeth , Pereira, Alberto M. , Petersenn, Stephan , Pivonello, Rosario , Tabarin, Antoine , Valassi, Elena , Vila, Greisa , Brown, Marielle
The Journal of Clinical Endocrinology & Metabolism | July 15, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Context Biochemical test results are central to clinical decision-making for the diagnosis and management of Cushing syndrome (CS). With emerging research and increasing availability of different tests, updated consensus on the utility of these biomarkers is warranted. Objective To establish an updated consensus on the role of biomarkers in the diagnosis and monitoring of adrenocorticotropic hormone-dependent CS, address novel therapeutic approaches, and identify areas for future research. Design A modified 2-round Delphi panel was conducted. Consensus was defined as ≥70% agreement/disagreement for Likert-scale statements or ≥70% selection of the same option for single-choice questions. Setting Participants represented a range of international expertise. Participants Forty-one participants took part in the Delphi panel, with no attrition between rounds (one nonclinician was not required to complete the second round). An 8-member Steering Committee guided statement development. Results Of statements designed to reach consensus, 45% (14/31) and 44% (11/25) statements reached consensus in Rounds 1 and 2, respectively. Notably, most panelists reported the use of late-night salivary cortisol for diagnosis of mild CS and for monitoring following pituitary surgery or medical or radiation therapy. Most panelists responded that block-and-replace therapies can be considered in patients with cyclical or severe CS, and consensus was reached that restoration of circadian rhythm is a treatment goal for patients with CS. Conclusion Areas of alignment among experts on the diagnosis and monitoring of CS are presented. The findings from this study are intended to support clinicians in their clinical decision-making and highlight priority areas for future research.