Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment
Primary result · Change in HbA1cResult — go to the resultLSM difference −1.32 % 95% CI −1.81 to −0.83Authors' conclusion
In individuals with inadequately controlled T2D and hypercortisolism, cortisol-directed medical therapy with mifepristone reduced HbA1c, with a manageable tolerability profile.
Study context
- Population
- Individuals with T2D (HbA1c 7.5%-11.5% [58–102 mmol/mol] on multiple medications) and hypercortisolism (by dexamethasone suppression test); mean baseline HbA1c 8.55% (69.9 mmol/mol)randomized 2:1
- Participants
- 136 individuals
- Comparison
- Mifepristone vs placebo for 24 weeks
- Mifepristonen = 91
- Placebon = 45reference
- Primary endpoint
- Change in HbA1c
- Follow-up
- 24 weeks
Methodological detailsprospective, multicenter, double-blind, placebo-controlled, stratified by presence/absence of adrenal imaging abnormality
- Prospective
- Multicenter
- Double-blind
- Placebo-controlled
- Stratified by presence/absence of adrenal imaging abnormality
Primary result
As reported in the abstract
Least squares mean (LSM) difference
−1.32 %
95% CI −1.81 to −0.83
P < 0.001
Mifepristonevs Placebo
LSM difference −1.32 % (95% CI −1.81 to −0.83); P < 0.001
Secondary outcomes
| Outcome | Placebo-adjusted LSM difference (kg) (95% CI) | |
|---|---|---|
| Change in body weight | −5.12 (−8.20 to −2.03) | |
| −10−505Difference, kg (linear scale) |
| Outcome | Placebo-adjusted LSM difference (cm) (CI) | |
|---|---|---|
| Change in waist circumference | −5.1 (−8.23 to −1.99) | |
| −10−505Difference, cm (linear scale) |
Safety
Discontinuation of therapy
Adverse events with mifepristone (>10% of participants)
- Hypokalemia, fatigue, nausea, vomiting, headache, peripheral edema, diarrhea and dizziness, consistent with mifepristone's known tolerability profile
- Increases in blood pressure also occurred
Original publication
Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment. Diabetes Care. Published 23 June 2025. doi:10.
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