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Taking people in United StatesPhase 4

Isturisa for Mild Autonomous Cortisol Secretion, an Adrenal Condition

Tests Isturisa in adults with mild autonomous cortisol secretion.

Plain-language title generated from the registry record
Registry title: Isturisa Treatment in Mild Autonomous Cortisol Secretion( MACS)

Key facts

Where
Baltimore, United StatesSee the site
Phase
Phase 4

Where in United States

  • Johns Hopkins University School Of MedicineBaltimore, United StatesTaking people

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Trial details

Who runs it
Johns Hopkins University
Trial code
NCT07247058
Record updated
23 October 2026
Original description
To characterize the impact of Isturisa on clinical features and comorbidities associated with MACS. The investigators hypothesize that patients treated with Isturisa will exhibit significantly better metabolic indicators (such as fasting glucose, HbA1c, and lipid profile), blood pressure, weight, body composition and bone mineral density than at Baseline. The investigators also assess the effect of Isturisa on quality of life and psychological symptoms in patients with MACS. The investigators hypothesize that treatment with Isturisa will lead to significant improvements in quality-of-life scores and reductions in depression scores compared to Baseline.Read full original descriptionShow less

Isturisa in Management of Mild Autonomous Cortisol Secretion (MACS)

To characterize the impact of Isturisa on clinical features and comorbidities associated with MACS. The investigators hypothesize that patients treated with Isturisa will exhibit significantly better metabolic indicators (such as fasting glucose, HbA1c, and lipid profile), blood pressure, weight, body composition and bone mineral density than at Baseline. The investigators also assess the effect of Isturisa on quality of life and psychological symptoms in patients with MACS. The investigators hypothesize that treatment with Isturisa will lead to significant improvements in quality-of-life scores and reductions in depression scores compared to Baseline.

Exclusion: Has used or plans to use any treatments for MACS within 12 weeks before Screening and throughout the study, including metyrapone, mifepristone, ketoconazole, fluconazole, or any investigational drug for the treatment of hypercortisolism; Has severe, uncontrolled hypertension (mean SBP >170 mm Hg or mean Diastolic Blood Pressure (DBP) >110 mm Hg at Screening); Has severe renal insufficiency (glomerular filtration rate ≤29 mL/min at Baseline); Has adrenocortical carcinoma, or the adrenal images are suspicious for an underlying malignancy; Has poorly controlled DM (HbA1c >11% at Screening); Has abnormal liver test results (total bilirubin >1.5×ULN or elevated alanine aminotransferase or aspartate aminotransferase >3×ULN at Baseline); Has prolonged QT interval corrected for heart rate using Fridericia's equation (QTcF) (>450 ms for men and >470 ms for women) with a normal QRS interval (<120 ms) or QTcF interval >500 ms with wide QRS interval (≥120 ms); Female patients of childbearing potential who cannot use a highly effective method of contraception, including all women <50 years old, women whose surgical sterilization was performed <6 months ago; Has uncontrolled, clinically significant hypothyroidism or hyperthyroidism; Has persistent atrial fibrillation; Has uncorrected hypokalemia; Has autonomous co-secretion of aldosterone; Has plans for adrenalectomy or nodulectomy during the study; Pregnancy, lactating, or intends to become pregnant in the next 2 years.

Age >18 years old with confirmed mild autonomous cortisol secretion (MACS) Cushing's syndrome, defined by:; At least two abnormal 1 mg Dexamethasone suppression tests (Cortisol > 1.8 ug/dL at 8-9 am after taking 1 mg dexamethasone at 11 pm) with appropriate dexamethasone level for the assay (last level within 3 months before enrollment); Having at least two early morning fasting ACTH <15 pg/mL (last level within 3 months before enrollment); Presence of at least one of the following comorbidities:; The presence of prediabetes or Type 2 diabetes mellitus (T2DM): fasting plasma glucose ≥100 mg/dL and/or 2-hour Oral Glucose Tolerance Test (OGTT) glucose ≥140 mg/dL, or HbA1c ≥5.7%; Systolic hypertension is defined as a mean Systolic Blood Pressure (SBP) ≥130 mmHg after 5 min rest in a seated position (mean of 3 blood pressure measurements 5 minutes apart) irrespective of the number of anti-hypertensive medications; BMI >30 kg/m2; The presence of an adrenal adenoma or hyperplasia, as determined by CT or MRI studies; Negative urine pregnancy test at Baseline (urine) for women of childbearing potential.

ClinicalTrials.gov NCT07247058