IMPACT-MACS: Adrenalectomy vs Semaglutide for Metabolic Outcomes in Mild Autonomous Cortisol Secretion
Key facts
- Where
- Dallas, United StatesSee the site
Where in United States
- University of Texas Southwestern Medical CenterDallas, United StatesContact: Oksana Hamidi, DO, MSCSTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- University of Texas Southwestern Medical Center
- Trial code
- NCT07361874
- Record updated
- 27 March 2026
- Original description
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.Read full original descriptionShow less
IMPACT-MACS Study: Investigating the Mechanisms, Pathophysiology, and Cardiometabolic Treatment in Mild Autonomous Cortisol Secretion
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
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; Prior obesity/diabetes surgery; Contraindication to surgery delay; Type 1 diabetes or other diabetes types; Severe organ disease; Weight change >5 kg in past 90 days; Recent pancreatitis; Pregnancy, breastfeeding; Contraindication to semaglutide; Chronic glucocorticoid use.