POMC and Cowden syndrome 1: However, anecdotal cases have shown that osilodrostat, in combination with etomidate in a patient with severe adrenocorticotropic hormone (ACTH)-dependent CS, as well as in combination with ketoconazole in a patient with ACTH-independent CS, was highly and rapidly effective, with a significant improvement in clinical picture, while being well-tolerated.6,24,25