PMC:3724972 / 27635-28559 JSONTXT

{"project":"2_test","denotations":[{"id":"23673515-22369976-63233680","span":{"begin":209,"end":211},"obj":"22369976"},{"id":"23673515-8043488-63233681","span":{"begin":376,"end":378},"obj":"8043488"},{"id":"23673515-18413427-63233682","span":{"begin":576,"end":578},"obj":"18413427"},{"id":"23673515-20478050-63233683","span":{"begin":580,"end":582},"obj":"20478050"},{"id":"23673515-18166822-63233684","span":{"begin":648,"end":650},"obj":"18166822"},{"id":"23673515-22815335-63233685","span":{"begin":652,"end":654},"obj":"22815335"},{"id":"23673515-22369976-63233686","span":{"begin":781,"end":783},"obj":"22369976"},{"id":"23673515-22369976-63233687","span":{"begin":920,"end":922},"obj":"22369976"}],"text":"Drugs inhibiting adrenocortical steroidogenesis include ketoconazole, mitotane, etomidate and metyrapone. In general, use of these drugs requires careful clinical monitoring for adverse effects, including AI [77]. Ketoconazole has been widely used to treat CD because it inhibits several steps in adrenal steroid synthesis and reduces UFC in the majority of patients with CD [78]. However, it also inhibits androgen synthesis and is associated with liver toxicity in some patients [79]. There is little prospective information on the long-term use of adrenal-targeted agents [11, 80]; however, 1 small retrospective study showed promising results [81, 82]. Mitotane also inhibits several steps in steroidogenesis, and can be adrenolytic during long-term therapy at doses \u003e4 g/day [77]. Because mitotane is sequestered in adipose tissue and eliminated slowly, pregnancy must be avoided for 5 years after discontinuation [77]."}