Common Contracts
1 similar Shared Care Guideline contracts
Shared Care Guideline Version 1Shared Care Guideline • June 20th, 2021
Metyrapone Medical Management of Cushing’s Disease (CD) Introduction This shared care agreement outlines the responsibilities between the specialist and the generalist for managing the prescribing of Metyrapone for indications listed below. Indication Endocrine Society guidance recommends Metyrapone as the first line treatment option for the medical management of Cushing’s Syndrome and usual practice is to stabilize patients on this steroidogenesis inhibitor pre-operatively. It is recommended also as second-line treatment after Trans- Sphenoidal Surgery in patients with CD, either with or without Radiotherapy/radiosurgery; as primary treatment of Ectopic ACTH Secretion (EAS) in patients with occult or metastatic EAS; and as adjunctive treatment to reduce cortisol levels in adrenocortical carcinoma (ACC). It is also recommended as the de facto glucocorticoid antagonist of choice in patients who are not surgical candidates (eg TSS or Bilateral Adrenalectomy) or who have persistent dise
