News|Articles|October 28, 2026

The Evolving Standard of Care of Classic Congenital Adrenal Hyperplasia

Sponsored by Neurocrine Biosciences, Inc. Wenyu Huang, M.D. and Susan were paid to participate in this podcast.

In this episode, produced by HCPLive, host Rachel Groeneweg an employee of Neurocrine Biosciences led a discussion with Dr. Wenyu Huang, a leading endocrinologist and associate professor at the Division of Endocrinology, Metabolism and Molecular Medicine at Northwestern University Feinberg School of Medicine, and Susan, a Texas resident living with classic congenital adrenal hyperplasia (CAH). Together they explored the evolving management of classic CAH and the role of CRENESSITY® (crinecerfont), an adjunctive treatment to glucocorticoid (GC) replacement to control androgens in adults and pediatric patients 4 years of age and older with classic CAH.¹ Susan also shared her lived experience with classic CAH and the treatment.

Key Takeaways

Classic CAH is a rare genetic condition marked by cortisol deficiency and ACTH-driven adrenal androgen excess, with symptoms and complications that can vary across life stages and individual patient experiences.^2,3
Dr. Huang explains that historically, GC-only treatment required a balancing act, as higher steroid doses may help control adrenal androgens but can increase short- and long-term risks.^4,5
Susan shares her experience living with classic CAH and with CRENESSITY, the first and only FDA-approved CRF_¹ receptor antagonist for classic CAH, which is used as an adjunct to GC replacement therapy to help control adrenal androgens.¹

SELECT IMPORTANT SAFETY INFORMATION

CRENESSITY is contraindicated in patients with hypersensitivity to crinecerfont or any excipients of CRENESSITY.

Please see additional Important Safety Information, below.

Understanding Classic CAH

The discussion begins with an overview of classic CAH and its effects on adrenal steroid hormone production, which can lead to cortisol deficiency, aldosterone deficiency in some patients, and excess adrenal androgen production.² Dr. Huang explained that GCs have historically been used to address both cortisol replacement and androgen control, but managing adrenal androgens often requires supraphysiologic dosing, which can create short- and long-term risks.^4,5

Living with Classic CAH

Susan shared her personal experience living with classic CAH, emphasizing that each person’s experience with classic CAH is different and that sharing personal stories can help build understanding within the community.

Dr. Huang discussed how classic CAH can affect patients differently across life stages and emphasized the importance of recognizing this variability when caring for patients with the condition.

The Role of CRENESSITY

Dr. Huang explained that CRENESSITY helps reduce ACTH and adrenal androgen production by blocking CRF activity.^1,5 He noted that this may allow patients to lower supraphysiologic GC doses while maintaining androgen control.¹ He also emphasized that CRENESSITY is an adjunctive treatment, not a replacement for GCs, which remain necessary for cortisol replacement and stress dosing when needed.¹

Dr. Huang highlighted findings from the Phase 3 CAHtalyst® program showing that CRENESSITY allowed patients to reduce GC doses while maintaining or improving androgen control and was generally well tolerated.^4,5

Susan discussed her experience participating in the CAHtalyst study and starting CRENESSITY, sharing that her steroid dose came down while her androgen levels remained controlled.

Looking Ahead for the CAH Community

The episode concluded with a discussion of what CRENESSITY may mean for the CAH community. Dr. Huang described it as an important advancement because it may allow some patients to reduce supraphysiologic GC use. Susan shared that CRENESSITY has given her hope for the CAH community and emphasized the importance of greater awareness and education about the condition.

To learn more about CRENESSITY, visit https://www.crenessity.com/hcp.

INDICATION

CRENESSITY (crinecerfont) is indicated as adjunctive treatment to glucocorticoid replacement to control androgens in adults and pediatric patients 4 years of age and older with classic congenital adrenal hyperplasia (CAH).

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

CRENESSITY is contraindicated in patients with hypersensitivity to crinecerfont or any excipients of CRENESSITY.

WARNINGS AND PRECAUTIONS

Hypersensitivity Reactions. A hypersensitivity reaction, including throat tightness, angioedema, and generalized rash, occurred in a subject after 3 days of treatment with CRENESSITY. If a clinically significant hypersensitivity reaction occurs, initiate appropriate therapy and discontinue CRENESSITY.

Risk of Acute Adrenal Insufficiency or Adrenal Crisis with Inadequate Concomitant Glucocorticoid Therapy. Acute adrenal insufficiency or adrenal crisis, which is potentially life-threatening, can occur in patients with underlying adrenal insufficiency who are on inadequate daily glucocorticoid doses, especially in situations associated with increased cortisol need, such as acute intercurrent illness, serious trauma, or surgical procedures. Continue glucocorticoids upon initiation of and during treatment with CRENESSITY. Do not reduce the glucocorticoid dose below the dose required for cortisol replacement. Patients should continue to use stress dosing of glucocorticoids in cases of increased cortisol needs.

ADVERSE REACTIONS

In adult patients, the most common adverse reactions (at least 4% for CRENESSITY and greater than placebo) are fatigue, headache, dizziness, arthralgia, back pain, decreased appetite, and myalgia.

In pediatric patients, the most common adverse reactions (at least 4% for CRENESSITY and greater than placebo) are headache, abdominal pain, fatigue, nasal congestion, and epistaxis.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch at www.fda.gov/medwatch or call 1-800-FDA-1088.

Dosage Forms and Strengths:

CRENESSITY is available in 50 mg and 100 mg capsules, and as an oral solution of 50 mg/mL.

Please see full Prescribing Information.

Author Bios

Wenyu Huang, MD is an adult endocrinologist at Northwestern University Feinberg School of Medicine with extensive experience caring for adults with classic congenital adrenal hyperplasia. His clinical work focuses on balancing glucocorticoid therapy with androgen control while addressing the metabolic, skeletal, reproductive, and psychological impacts of long-term disease management. Dr. Wenyu Huang has been compensated by Neurocrine Biosciences to participate in this podcast and share perspectives.

Susan is a licensed aircraft mechanic and compliance auditor in quality assurance who has lived an active, travel-filled life despite her congenital adrenal hyperplasia (CAH) diagnosis at just seven days old. Since then, Susan has traveled to 35 countries. In 2021, she participated in the CAHtalyst® Adult study and has taken CRENESSITY (crinecerfont) ever since. Susan has been compensated by Neurocrine Biosciences to participate in this podcast and share perspectives.

References

1. CRENESSITY [package insert]. Neurocrine Biosciences, Inc.; 2023.

2. Congenital adrenal hyperplasia. National Organization for Rare Disorders. Updated June 8, 2023. Accessed June 15, 2026. https://rarediseases.org/rare-diseases/congenital-adrenal-hyperplasia/

3. Congenital adrenal hyperplasia. Johns Hopkins Medicine. Accessed December 13, 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/congenital-adrenal-hyperplasia

4. Auchus RJ, Hamidi O, Pivonello R, et al; CAHtalyst Adult Trial Investigators. Phase 3 trial of crinecerfont in adult congenital adrenal hyperplasia. N Engl J Med. 2024;391(6):504-514. doi:10.1056/NEJMoa2404656

5. Sarafoglou K, Kim MS, Lodish M, et al; CAHtalyst Pediatric Trial Investigators. Phase 3 trial of crinecerfont in pediatric congenital adrenal hyperplasia. N Engl J Med. 2024;391(6):493-503. doi:10.1056/NEJMoa2404655