Crinetics Receives FDA Orphan Drug Designation for Atumelnant in the Treatment of Congenital Adrenal Hyperplasia (CAH)

Core Insights - Crinetics Pharmaceuticals received Orphan Drug Designation from the FDA for atumelnant, a novel oral ACTH receptor antagonist aimed at treating classic congenital adrenal hyperplasia (CAH) [1][4] - Atumelnant is the first and only small molecule ACTH receptor antagonist in clinical development, highlighting its potential significance in addressing unmet medical needs in CAH [1][5] Company Overview - Crinetics Pharmaceuticals is a clinical-stage pharmaceutical company focused on developing novel therapeutics for endocrine diseases and related tumors, with all drug candidates being small molecules from in-house discovery efforts [6] - The company's lead candidate, PALSONIFY™ (paltusotine), is in clinical development for acromegaly and carcinoid syndrome associated with neuroendocrine tumors, while atumelnant targets congenital adrenal hyperplasia and ACTH-dependent Cushing's syndrome [6] Clinical Development - The Phase 2 TouCAHn trial of atumelnant showed robust positive topline results, including up to an 80% mean reduction in androstenedione and significant improvements in clinical signs and symptoms of CAH [2][3] - Crinetics plans to initiate the CALM-CAH Phase 3 study in adults and the BALANCE-CAH Phase 2/3 study in pediatrics in the second half of 2025 [2] Mechanism of Action - Atumelnant acts selectively at the melanocortin type 2 receptor (MC2R) on the adrenal gland, demonstrating strong binding affinity and suppression of glucocorticoids and androgens controlled by ACTH [5] - The innovative mechanism aims to restore normal levels of adrenal androgens and reduce glucocorticoid supplementation to physiological levels, improving the quality of life for patients [2][3]