Evidence map›Paper›PMID 41705018›Full record

ArticleEClinicalMedicine2026

Metabolic effects of metyrapone treatment in patients with mild autonomous cortisol secretion: a prospective proof-of-concept trial.

Helena Niziolek, Ivica Just, Anna Tosin, Clemens Baumgartner, Konrad Körmöczi, Luise Bellach, Paul Fellinger, Hannes Beiglböck, Hana Skuciova, Greta Gericke and 12 more

Abstract read
In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Helena NiziolekDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Ivica JustDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Anna TosinDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Clemens BaumgartnerDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Konrad KörmöcziDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Luise BellachDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Paul FellingerDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Hannes BeiglböckDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Hana SkuciovaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Greta GerickeDivision of Endocrinology and Nephrology, Department of Medicine I, Klinik Landstraße, Vienna, Austria.
Stefan LässerDivision of Endocrinology and Nephrology, Department of Medicine I, Klinik Landstraße, Vienna, Austria.
Anton LugerDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Siegfried TrattnigDepartment of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria.
Alexandra Kautzky-WillerDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Marie Helene Schernthaner-ReiterDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Florian Wolfgang KieferDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Greisa VilaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Thomas SchererDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Michael LeutnerDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Martin KrssakDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Michael KrebsDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Peter WolfDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Mild autonomous cortisol secretion (MACS) is associated with an increased morbidity and mortality. Treatment options range from adrenalectomy to conservative management of comorbidities, but evidence on the effects of medical treatment is scarce. We therefore aimed to investigate the metabolic effects of evening metyrapone treatment in patients with MACS. Methods: We did a prospective, open-label, proof-of-concept trial (EudraCT: 2022-000161-40). Patients with uni-or bilateral adrenal incidentaloma and MACS defined by cortisol >1·8 μg/dL after 1 mg-dexamethasone-suppression-testing without clinical signs of Cushing's syndrome were included. Participants were investigated at baseline and after 12 weeks of treatment with metyrapone (500 mg at 6 p.m. and 250 mg at 10 p.m.). Intrahepatic lipid content (IHL) and abdominal visceral/subcutaneous fat mass were measured by magnetic resonance spectroscopy and imaging. Resting blood pressure measurements and blood sampling before and during an oral glucose tolerance test were conducted. IHL was the primary outcome parameter. Wilcoxon-signed-rank-tests were used for statistical analysis. Findings: Between May 2023 and September 2024, 19 patients were enrolled. Fifteen patients were included in the final analysis (12 female, median age 59 years [IQR 53-64]; median BMI 28 kg/m Interpretation: Treatment of MACS with evening doses of metyrapone lowers hepatic lipid content and improves the metabolic risk profile and might offer a novel therapeutic approach. Funding: Esteve (formerly HRA pharma) to the Medical University of Vienna (PI:PW).

Indexed as

Adrenal incidentalomaChronotherapyHypercortisolismMetyraponeMild autonomous cortisol secretion (MACS)

Identifiers

PMID41705018
PMCPMC12907678

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.