MOMENTUM Examines Hypercortisolism in Hypertension with Deepak L. Bhatt, MD

Corcept Therapeutics signaled the launch of the MOMENTUM clinical trial to establish the prevalence of endogenous hypercortisolism (Cushing’s syndrome) in patients with resistant hypertension.1

Announced on March 10, 2025, the trial will enroll 1000 patients with hypertension across 45 US sites and determine the presence of hypercortisolism by a dexamethasone suppression test (DST) value ≥1.8 µg/dL and dexamethasone levels ≥140 ng/dL.

“Resistant hypertension is a serious public health challenge. Patients whose hypertension remains in poor control despite receiving optimal care, including multiple medications, are at greater risk of cardiovascular morbidity and mortality,” said Deepak L. Bhatt, MD, MPH, MBA, director of the Mount Sinai Fuster Heart Hospital and the Dr. Valentin Fuster Professor of Cardiovascular Medicine at Icahn School of Medicine at Mount Sinai.1 “We hope the data from this MOMENTUM trial will expand our understanding of the challenges these patients face and open up new opportunities for treatment.”

The American Heart Association (AHA) defines hypercortisolism as elevated blood pressure despite the use of ≥3 antihypertensive medication classes, including a diuretic. Caused by excessive activity of cortisol, symptoms can vary, but most patients experience ≥1 manifestation, including hypertension, central obesity, elevated blood sugar, difficult-to-control type 2 diabetes (T2D), severe fatigue, and weak muscles.2

Corcept previously announced results from the Phase 4 CATALYST study of hypercortisolism in patients with difficult-to-control T2D. Enrolling 1055 patients across 36 US sites, the first part of the trial identified hypercortisolism in 21% of patients, particularly those with cardiovascular disease (CVD) and those on medication to manage diabetes.3

Further evidence from the treatment phase of the CATALYST trial showed the benefit of mifepristone (Korlym) in significantly improving hemoglobin A1c (HbA1c) for those with difficult-to-control T2D. Individuals treated with mifepristone achieved a clinically meaningful decrease from the baseline of 1.47% with mifepristone, compared with 0.15% for placebo (placebo-adjusted reduction, 1.32%; P <.0001).4

In a recent interview, HCPLive Cardiology spoke with Bhatt to learn more about the importance of the MOMENTUM trial in determining the role of hypercortisolism in resistant hypertension.

Relevant disclosures for Bhatt include Amarin, AstraZeneca, Sanofi, Pfizer, Roche, Amgen, and Eli Lilly and Company, among others.

References

1. Corcept Therapeutics initiates momentum trial to determine prevalence of hypercortisolism in patients with resistant hypertension. Corcept Therapeutics, Incorporated. March 10, 2025. Accessed March 17, 2025. https://ir.corcept.com/news-releases/news-release-details/corcept-therapeutics-initiates-momentum-trial-determine.

2. Carey RM, Calhoun DA, Bakris GL, et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018;72(5):e53-e90. doi:10.1161/HYP.0000000000000084

3. Campbell P. Catalyst proves hypercortisolism more common than previously known in type 2 diabetes. HCP Live. June 24, 2024. Accessed March 17, 2025. https://www.hcplive.com/view/catalyst-proves-hypercortisolism-more-common-than-previously-known-in-type-2-diabetes.

4. Iapoce C. Mifepristone notably reduces hba1c in treatment phase of Catalyst Trial. HCP Live. December 12, 2024. Accessed March 17, 2025. https://www.hcplive.com/view/mifepristone-notably-reduces-hba1c-in-treatment-phase-of-catalyst-trial.