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IMPACT-MACS: Adrenalectomy vs Semaglutide for Mild Autonomous Cortisol Secretion

This study is looking at how two treatments, adrenalectomy (surgery to remove one adrenal gland) and semaglutide (a medication for weight management), affect adults with mild autonomous cortisol secretion (MACS). MACS means your adrenal glands make a little too much cortisol, which can lead to health problems. The study wants to see which treatment better improves insulin resistance (how well your body uses sugar) and how they impact cortisol levels, body composition, blood pressure, and overall quality of life. You might be able to join if you are an adult with MACS or if you are an adult without adrenal problems but have a higher BMI and other health conditions. The main goal is to see how much insulin resistance changes after 26 weeks of treatment.

Study design
This is an interventional study with 75 planned participants. It includes a randomized comparison between adrenalectomy and semaglutide for people with MACS, and a comparison of semaglutide effects in people with MACS versus matched controls.
What's involved
Not specified in the trial record.
Compensation
Not stated in the trial record.
Follow-up
The primary outcome is measured from baseline to Week 26.

AI-generated from the public study record. Only the study team can confirm whether you're eligible — confirm details with them before making decisions.

NCT07361874

IMPACT-MACS: Adrenalectomy vs Semaglutide for Metabolic Outcomes in Mild Autonomous Cortisol Secretion

Recruiting
NAAges 18+InterventionalTreatment
University of Texas Southwestern Medical Center
~75 participants
Updated 2026-03-27 on ClinicalTrials.gov
What's tested:Intervention 1: AdrenalectomyIntervention 2: Semaglutide

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Change in Insulin Sensitivity (M-value), mg/kg/min
Measured over Baseline to Week 26

Conditions

Mild Autonomous Cortisol Secretion (MACS)
Autonomous Cortisol Secretion (ACS)
Subclinical Cushing's
Mild Autonomous Cortisol Excess

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Mild Autonomous Cortisol Secretion

NCT07361874

Where you'd take part

This study runs at 1 site. They're the same protocol — you choose where, and that choice sets who your contact draft is addressed to.

  • University of Texas Southwestern Medical Center

    Dallas, Texasstudy coordinator listed

    Recruiting

Sites open and close at different times, so the status above is per site — it can differ from the study's overall status.

Who to contact

Oksana Hamidi, DO, MSCS
[email protected]
214-645-6397
Email the study team

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Eligibility criteria

Inclusion

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

Exclusion

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
Contraindication to surgery delay
Chronic glucocorticoid use

What this trial measures

  • Change in Insulin Sensitivity (M-value), mg/kg/minBaseline to Week 26

    Hyperinsulinemic-euglycemic clamp