IMPACT-MACS: Adrenalectomy vs Semaglutide for Metabolic Outcomes in Mild Autonomous Cortisol Secretion
Eligible age
18+ yrs
Accepts
All genders
Locations
1 state
Healthy volunteers
No
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About this study
The goal of this study is to learn how two treatments-adrenalectomy (surgical removal of an adrenal gland) and semaglutide (a medication used for weight management)-affect insulin resistance and cortisol regulation in adults with mild autonomous cortisol secretion (MACS). The study will also learn how these treatments impact body composition, blood pressure, cholesterol, inflammation, muscle strength, and quality of life. The main questions the study aims to answer are: 1. Does adrenalectomy or semaglutide improve insulin resistance more in people with MACS? 2. How do these treatments change cortisol patterns and other cardiometabolic risk factors? 3. Do people with MACS respond differently to semaglutide compared to matched adults without MACS? Participants will: 1. Receive either adrenalectomy or semaglutide if they have MACS, or semaglutide if they are matched controls 2. Complete clinic visits and phone visits over about 26-30 weeks 3. Undergo metabolic testing such as blood tests, urine steroid profiling, body composition scans, blood pressure monitoring, muscle strength testing, and questionnaires about health and well-being
Sponsor: University of Texas Southwestern Medical Center
You may qualify if…
- ✓ Adults ≥18 years
- ✓ MACS groups: adrenal adenoma + DST cortisol \>1.8 µg/dL + no overt Cushing + eligible for adrenalectomy
- ✓ Willingness to postpone surgery 6 months if randomized
- ✓ Controls: no adrenal abnormalities + normal DST + BMI ≥27 + ≥2 cardiometabolic conditions
- ✓ Stable medication doses for ≥4 weeks
- ✓ Negative pregnancy test if applicable
You may not qualify if…
- ✕ Prior GLP-1 RA within 90 days
- ✕ Weight change \>5 kg in past 90 days
- ✕ Prior obesity/diabetes surgery
- ✕ Type 1 diabetes or other diabetes types
- ✕ Severe organ disease
- ✕ Recent pancreatitis
- ✕ Pregnancy, breastfeeding
- ✕ Contraindication to semaglutide
Where it's recruiting
Dallas
Source: ClinicalTrials.gov · NCT07361874 · last updated 2026-03-27