ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1665985
Management of Patients with Cushing's Disease in the Gulf Region: A Delphi Consensus Recommendation
Provisionally accepted
Mussa H Almalki1,2*
Tarik Elhadd3
Khaled Aldahmani4,5,6Aishah Ekhzaimy7Abdullah Alqanaei8Hasan F Jamal9Abdulla Alfutaisi10Moeber Mahzari11,12,13Salem A Beshyah14,15
Ali Alzahrani16,2- 1King Fahd Medical City, Riyadh, Saudi Arabia
- 2Alfaisal University College of Medicine, Riyadh, Saudi Arabia
- 3Hamad Medical Corporation, Doha, Qatar
- 4Tawam Hospital, Al Ain, United Arab Emirates
- 5United Arab Emirates University College of Medicine and Health Sciences, Al Ain, United Arab Emirates
- 6Sh Tahnoon Bin Mohammed Medical City, Al Ain, United Arab Emirates
- 7King Saud University, Riyadh, Saudi Arabia
- 8Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, Kuwait
- 9Salmaniya Medical Complex, Manama, Bahrain
- 10Sultan Qaboos University College of Medicine and Health Sciences, Seeb, Oman
- 11King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, Saudi Arabia
- 12King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- 13Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- 14University of Dubai, Dubai, United Arab Emirates
- 15Bareen International Hospital, Abu Dhabi, United Arab Emirates
- 16King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Abstract Introduction Cushing's disease (CD), most commonly caused by ACTH-secreting pituitary adenomas, is a rare but serious endocrine disorder characterized by chronic hypercortisolism. CD is associated with significant morbidity and increased mortality, necessitating timely and effective intervention. Objectives This study aimed to establish consensus-based clinical practice guidelines for managing CD in the Arabian Gulf region, where disparities in healthcare infrastructure and access to therapies present challenges to optimal care delivery. Methods A Delphi consensus approach was employed, involving 83 endocrinologists with ≥5 years of independent practice from the six Gulf Cooperation Council (GCC) countries. A scientific committee develpoed 21 statements covering surgical, medical, and radiotherapeutic management. Consensus was predefined as ≥80% agreement on a 5-point Likert scale. Results
Keywords: Cushing disease (CD), Delphi consensus, Gulf region, Transphenoid surgery, pasireotide, Steroidogenesis inhibitors, Radiotheapy, Bilateral adrenalectomy
Received: 14 Jul 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Almalki, Elhadd, Aldahmani, Ekhzaimy, Alqanaei, Jamal, Alfutaisi, Mahzari, Beshyah and Alzahrani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mussa H Almalki, m2malki@yahoo.com
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