Practice-changing landmark trials in endocrinology and metabolism, organized for rapid clinical review, exam preparation, teaching, and evidence-based patient care.
In CHIRACIC, adrenalectomy improved home-blood-pressure normotension with less medication versus conservative management in unilateral mild autonomous cortisol secretion-associated hypertension.
In ACROINNOVA 1, monthly self-injected CAM2029 maintained IGF-1 control in 72.2% of adults with controlled acromegaly versus 37.5% on placebo withdrawal.
In an open-label Graves disease RCT, methotrexate 10 mg weekly added to methimazole increased treatment withdrawal at 18 months, but remains investigational.
In gestational diabetes requiring medication, metformin-first oral therapy with glyburide rescue did not prove noninferior to insulin for preventing large-for-gestational-age birth.
In early postmenopausal women aged 50 to 60 years, zoledronate at baseline and 5 years reduced 10-year morphometric vertebral fractures from 11.1% to 6.3%.
In the IoN non-inferiority RCT, omitting postoperative radioiodine after total thyroidectomy produced 5-year recurrence-free survival of 97.9% versus 96.3% with ablation in selected low-risk thyroid cancer.
A healthy-volunteer pharmacokinetic crossover trial found magnesium aspartate reduced levothyroxine absorption by 12 percent, while magnesium citrate had a smaller, non-significant effect. PICO summary and expert commentary.
CARDS demonstrated that atorvastatin 10 mg reduces major cardiovascular events by 37% and stroke by 48% in patients with type 2 diabetes and normal to mildly elevated LDL-cholesterol without prior CVD, confirming that cardiovascular risk rather than LDL level should determine statin initiation and establishing universal statin use in primary cardiovascular prevention for type 2 diabetes.
HPS demonstrated that simvastatin reduces major vascular events by 24% across all high-risk patients regardless of baseline LDL-cholesterol level, including those with diabetes without established coronary disease, eliminating the treatment threshold concept and establishing absolute cardiovascular risk as the primary criterion for statin therapy — one of the most influential results in preventive cardiology.
WOSCOPS demonstrated that pravastatin reduces the combined incidence of nonfatal MI and coronary death by 31% in men with hypercholesterolaemia and no prior MI, establishing the primary prevention indication for statin therapy and providing the first large randomised evidence for population-level lipid lowering in high-risk individuals without established cardiovascular disease.
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