Diurnal Ltd., a Neurocrine Biosciences Company, Presents Phase 3 Extension Study Data for Modified-Release Hydrocortisone in Patients with Congenital Adrenal Hyperplasia at ENDO 2023
Management of CAH involves not only replacing cortisol deficiency but also managing elevated adrenal androgen levels, which are responsible for the detrimental symptoms associated with hyperandrogenism, such as virilization in females and abnormalities in growth leading to short stature and early puberty. Current treatment guidelines recommend a target daily hydrocortisone dose of ≤25 mg (or equivalent dose of prednisone, prednisolone, or dexamethasone) in adult (fully grown) patients with CAH. However, hydrocortisone doses of >25 mg are often necessary to lower adrenal androgens in CAH. Thus, physicians treating CAH patients typically face a difficult dilemma of trying to manage the androgen excess while also trying to avoid the well-known consequences of chronic glucocorticoid overexposure.
The post hoc analyses examined total glucocorticoid daily dose and 9:00 a.m. 17-hydroxyprogesterone (17-OHP) levels in patients treated with modified-release hydrocortisone in an open-label Phase 3 extension study. Of the 71 patients who completed 24 months in the Phase 3 extension study at the time of the interim cut, 64 patients had 9:00 a.m. 17-OHP data for analysis. After 24 months of treatment, median daily hydrocortisone dose was reduced from 30 mg to 20 mg. The number of patients achieving lower androgen levels while receiving ≤25 mg of hydrocortisone per day increased significantly, with 48 percent of the subjects achieving 17-OHP levels <36 nmol/L compared with 31 percent at baseline. See the abstract (Poster # P 72; Improved Biochemical Control with Dose Reduction in Chronic Glucocorticoid Therapy: A Phase 3 Extension Study of CHRONOCORT® (EFMODY®) in the Treatment of Congenital Adrenal Hyperplasia) for more information here.
"These analyses help demonstrate the impact of modified-release hydrocortisone as a potential treatment for adults with congenital adrenal hyperplasia by delivering cortisol in a manner that matches the body's natural circadian rhythm," said Eiry W. Roberts, M.D., Chief Medical Officer at Neurocrine Biosciences.
About Modified-Release Hydrocortisone
Diurnal Ltd. developed modified-release hydrocortisone, a preparation of hydrocortisone that has been specifically designed to replicate the natural circadian rhythm of cortisol, when given in a twice-a-day "toothbrush" regimen, (administered last thing at night before sleep and first thing in the morning on waking). In 2021, modified-release hydrocortisone (EFMODY®) received marketing authorization for the treatment of congenital adrenal hyperplasia from the Medicines and Healthcare products Regulatory Agency (MHRA) in
About Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia is a group of rare genetic disorders in which a gene mutation results in the deficiency of one of the enzymes that is involved in the production of adrenal hormones. The most common mutation is to the gene encoding the adrenal enzyme 21-hydroxylase, which is responsible for the synthesis of cortisol in the adrenal glands. The disorder is associated with low cortisol levels that can be life-threatening and excess adrenal androgen that can lead to virilization in females and abnormalities in growth leading to short stature and early puberty.
About Neurocrine Biosciences
Neurocrine Biosciences is a leading neuroscience-focused, biopharmaceutical company with a simple purpose: to relieve suffering for people with great needs, but few options. We are dedicated to discovering and developing life-changing treatments for patients with under-addressed neurological, neuroendocrine, and neuropsychiatric disorders. The company's diverse portfolio includes FDA-approved treatments for tardive dyskinesia, Parkinson's disease, endometriosis* and uterine fibroids*, as well as a robust pipeline including multiple compounds in mid- to late-phase clinical development across our core therapeutic areas. For three decades, we have applied our unique insight into neuroscience and the interconnections between brain and body systems to treat complex conditions. We relentlessly pursue medicines to ease the burden of debilitating diseases and disorders, because you deserve brave science. For more information, visit neurocrine.com, and follow the company on LinkedIn, Twitter, and Facebook. (*in collaboration with AbbVie)
NEUROCRINE and the Neurocrine logo are registered trademarks of Neurocrine Biosciences, Inc. EFMODY is a registered trademark of Diurnal Ltd.
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