New hypercortisolism findings reshape diabetes and hypertension treatment approaches

New findings on hypercortisolism in patients with resistant hypertension and type 2 diabetes were revealed at the American Diabetes Association’s 86th Scientific Sessions. The data, presented by Corcept Therapeutics Incorporated, came from its CATALYST and MOMENTUM trials, showing a higher-than-expected prevalence of the condition in these groups.

The studies also highlighted the potential benefits of Korlym, a cortisol-modulating drug, in improving key health markers for affected patients.

The CATALYST trial focused on patients with difficult-to-control type 2 diabetes. Results showed that 24% of these individuals had hypercortisolism. Among those with both resistant hypertension and type 2 diabetes, the prevalence rose to 36.6% in CATALYST and 32.6% in MOMENTUM.

Patients treated with Korlym in the CATALYST trial saw significant improvements. Their HbA1c levels dropped by 1.3% compared to those on placebo. They also lost an average of 5.1 kg in body weight, reduced their BMI by 1.7 kg/m², and trimmed 5.1 cm from their waist circumference. For participants already taking GLP-1 receptor agonists or tirzepatide, the addition of Korlym led to even greater reductions in HbA1c, weight, BMI, and waist size. Meanwhile, the MOMENTUM trial found that 27.3% of patients with resistant hypertension alone had hypercortisolism. Lance Sloan, M.D., noted that cortisol modulation could enhance metabolic control, even in patients using advanced diabetes medications. Bill Guyer, PharmD, suggested the findings may encourage wider screening and better treatment strategies for hypercortisolism.

The trials indicate that hypercortisolism is common in patients with resistant hypertension and poorly managed type 2 diabetes. Korlym’s effects on weight, HbA1c, and other metabolic markers suggest it could play a role in managing these conditions. Researchers now hope for broader recognition of hypercortisolism and improved care for affected individuals.