Mifepristone treatment for mild autonomous cortisol secretion due to adrenal adenomas: A pilot study Journal Article

Authors: Belokovskaya, R.; Ravikumar, A.; Arumugam, D.; Izadmehr, S.; Goddard, G. M.; Geer, E. B.; Levine, A. C.
Article Title: Mifepristone treatment for mild autonomous cortisol secretion due to adrenal adenomas: A pilot study
Abstract: Objective: Adrenal incidentalomas are increasingly detected with the widespread use of thoracic and abdominal imaging. The most common secretory syndrome in adrenal nodules is autonomous cortisol secretion (ACS). Recent data show that even mild cortisol excess is associated with adverse outcomes. The glucocorticoid receptor antagonist mifepristone has been used in patients with overt Cushing syndrome and hyperglycemia. The purpose of our study was to determine the effect of mifepristone on metabolic parameters in patients with ACS and concomitant prediabetes or diabetes. Methods: Eight patients with either unilateral or bilateral adrenal nodules with ACS were included in the study. Fasting laboratory tests including glucose and insulin levels to calculate homeostatic model assessment for insulin resistance (HOMA-IR) were performed at baseline and again after either 3 months (3 patients) or 6 months (5 patients) on mifepristone 300 mg daily treatment. Patients also completed several validated surveys on mood and quality of life at baseline and follow-up. Results: There were significant reductions in fasting glucose measurements and insulin resistance as measured by HOMA-IR in the 6 of 8 study patients in whom these measurements were available (P = .03). Conclusion: This pilot study demonstrates that mifepristone treatment of ACS is associated with a significant decrease in fasting glucose and insulin resistance as measured by HOMA-IR scores. Mifepristone treatment of ACS may be considered as a medical option for patients with ACS due to adrenal adenomas with concomitant abnormal glucose parameters in whom surgical removal is not being considered. Copyright © 2019 AACE.
Journal Title: Endocrine Practice
Volume: 25
Issue: 8
ISSN: 1530-891X
Publisher: American Association of Clinical Endocrinologists  
Date Published: 2019-08-01
Start Page: 846
End Page: 853
Language: English
DOI: 10.4158/ep-2019-0047
PUBMED: 31070948
PROVIDER: scopus
Notes: Article -- Source: Scopus
Citation Impact
MSK Authors
  1. Eliza Brevoort Geer
    27 Geer