Efficacy and Tolerability of Metyrapone in Mild Autonomous Cortisol Secretion: Real‐World Findings From Clinical Practice
Authors' conclusion
Evening metyrapone was associated with significant reductions in systolic and diastolic blood pressure in patients with MACS, without causing adrenal insufficiency, indicating its potential safe clinical utility. A well-powered, controlled, prospective study is needed to validate these findings and comprehensively investigate the broader metabolic outcomes.
Study context
- Population
- Patients with mild autonomous cortisol secretion (MACS)matched controls
- Participants
- 15 vs 15
- Exposure
- Evening metyrapone vs matched controls
- Metyraponen = 15
- Controlsn = 15reference
- Outcome
- Adverse events, tolerability and cardiometabolic outcomes (systolic and diastolic BP, HbA1c, weight, non-HDL cholesterol)
- Follow-up
- 6 months
Methodological detailssingle-centre, longitudinal, age and sex-matched controls
- Single-centre
- Longitudinal
- Age and sex-matched controls
Main finding
As reported in the abstract
Change in BP
- Metyrapone vs Controls: P = 0.008
- Metyrapone vs Controls: P = 0.024
Observational data: associations, not effects.
Further findings
HbA1c, weight and non-HDL cholesterol · 6 months
- Differences between groups not statistically significant
Safety
Adverse events and tolerability · 6 months
- Metyrapone stopped due to side effects
- 2/15 patients
- No adrenal crises over 6 months
Original publication
Efficacy and Tolerability of Metyrapone in Mild Autonomous Cortisol Secretion: Real‐World Findings From Clinical Practice. Clin Endocrinol (Oxf). Published 6 November 2025. doi:10.
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