A Study in Pediatric Participants With Congenital Adrenal Hyperplasia (Balance-CAH)
Congenital Adrenal Hyperplasia · Classic Congenital Adrenal Hyperplasia
What this study involves
The registry says this study is recruiting. Individual locations may have different availability.
- Study type
- Interventional
- Phase
- Phase 2 / Phase 3
- Age range
- 1 years - 17 years
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 153 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
The purpose of this study is to evaluate the safety, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of atumelnant treatment in pediatric participants with classic congenital adrenal hyperplasia (CAH).
Read the full description
This Phase 2/3 plus open-label extension study is designed to evaluate the safety, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of atumelnant treatment in pediatric participants with classic CAH. Part A is a Phase 2, open-label, semi-sequential cohorts portion of the study. Part B is the Phase 3, double-blind, randomized, placebo controlled confirmatory portion of the study. Part C is the open-label extension (OLE) portion of the study. Participants in Part A and B are eligible to enroll in Part C (OLE).
A total of approximately 153 participants may be enrolled in the study (planned and optional cohorts) ages 1 to \< 18 years old.
The first 3 cohorts in Part A are for ages 12 to \<18 years and will be semi-sequential, and Safety Review Committee (SRC) review of data and approval to proceed is required prior to enrolling each subsequent cohort. The fourth cohort in Part A is for ages 1 to 11 years old and will begin after Cohorts 1 and 2 have been completed, additional requirements are fulfilled, and following SRC review of Cohorts 1 and 2 data.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
Inclusion Criteria:
Part A and B participants are eligible to be included in the study only if all of the following criteria apply:
1. Male or female at birth, between 1 to \<18 years of chronological age at the time of signing the Informed Consent Form (ICF).
2. Have a medically confirmed diagnosis of classic CAH due to 21-hydroxylase deficiency (21-OHD) based on standard medically accepted criteria such as elevated 17-OHP level, confirmed CYP21A2 genetic testing, positive newborn screening with confirmatory second tier testing, or cosyntropin stimulation.
3. Participants must have an elevated morning serum A4 level \>ULN during Screening obtained prior to morning glucocorticoid (GC) administration.
4. Participants must be on a stable supraphysiologic GC replacement therapy for at least one month prior to Screening.
5. Compliance, as judged per Investigator discretion, with GC replacement and mineralocorticoid replacement (if applicable) regimen documented during the Screening Period.
6. Biochemical euthyroidism as determined by the Investigator.
Part C inclusion criteria require participants to complete treatment in either Part A or Part B and in the Investigator's opinion it would benefit the participant to continue in Part C, regardless of age.
Exclusion Criteria:
Part A and Part B: Individuals in Part A and Part B who meet any of the following criteria will be excluded from participation in this study:
1. Diagnosis of any form of CAH other than classic 21-OHD.
2. Participants treated with other GCs within 30 days of Screening.
3. Stress dose of GC therapy within 2 weeks of start of Screening, defined as any dose above the normal maintenance dose, including but not limited to intravenous (IV) or intramuscular (IM) hydrocortisone.
4. Use of growth hormones within 1 week of start of Screening for short acting, or within 6 weeks of start of Screening for long acting.
5. Use of a corticotropin-releasing factor receptor antagonist within 14 days of Screening.
6. History of cancer excluding cured/treated dermal squamous or basal cell carcinoma or cervical carcinoma in situ.
7. Abnormal sleep/wake cycles (as determined by the Investigator).
8. Female participants who are pregnant or lactating.
9. Participants who have been dosed with an investigational drug (including atumelnant) in any prior clinical study within 60 days or 5 half-lives (whichever is longer) prior to the first dose.
10. Individuals in Part C who do not meet the Part C Inclusion Criteria.
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- Triple masked
Treatment (Part A)
Open-label, semi-sequential cohorts.
Drug: Atumelnant
Active Treatment (Part B)
Randomized, Parallel Arms, Double-Blind
Drug: Atumelnant
Placebo (Part B)
Randomized, Parallel Arms, Double-Blind
Drug: Placebo
Open-Label Treatment (Part C)
Open-label treatment period for participants entering Part C from Part A and B.
Drug: Atumelnant
Atumelnant DRUG
Atumelnant, tablets, once daily by mouth, weight-based dosing
Placebo DRUG
Placebo, tablets, once daily by mouth, weight-based dosing
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Change from baseline in morning serum androstenedione (A4) (Part A)
Time frame: Week 8
Not reported in this registry record.
Percent change from baseline in glucocorticoid (GC) daily dose while serum early morning A4 ≤Upper Limit of Normal (ULN) (Part B)
Time frame: Week 28
Not reported in this registry record.
Change from baseline in serum early morning A4 over time (Part C)
Time frame: Up to Week 260
Not reported in this registry record.
Secondary measures
Change from baseline in morning serum 17-hydroxyprogesterone (17-OHP) (Part A)
Time frame: Week 8
Not reported in this registry record.
Plasma and/or blood concentrations of atumelnant (Part A)
Time frame: Up to Week 8
Not reported in this registry record.
Change from baseline in serum early morning A4 (Part B)
Time frame: Week 4
Not reported in this registry record.
Change from baseline in serum early morning 17-OHP (Part B)
Time frame: Week 4
Not reported in this registry record.
Proportion of participants with physiologic GC dose while serum early morning A4 ≤ULN (Part B)
Time frame: Week 28
Not reported in this registry record.
Change from baseline in serum early morning 17-OHP over time (Part C)
Time frame: Up to Week 260
Not reported in this registry record.
Percent change from baseline in GC daily dose over time (Part C)
Time frame: Up to Week 260
Not reported in this registry record.
Proportion of participants with physiologic GC dose while serum early morning A4 ≤ULN over time (Part C)
Time frame: Up to Week 260
Not reported in this registry record.
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (53)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
53 locations
Children's Hospital Los AngelesLos Angeles, California, United StatesRecruiting
UCSF Ron Conway Gateway Medical BuildingSan Francisco, California, United StatesRecruiting
Ann and Robert H. Lurie Children's Hospital of ChicagoChicago, Illinois, United StatesRecruiting
Boston's Children's HospitalBoston, Massachusetts, United StatesRecruiting
University of MichiganAnn Arbor, Michigan, United StatesRecruiting
University of MinnesotaMinneapolis, Minnesota, United StatesRecruiting
Rutgers Robert Wood Johnson Medical SchoolNew Brunswick, New Jersey, United StatesRecruiting
Icahn School of Medicine at Mount Sinai-Mount Sinai HospitalNew York, New York, United StatesRecruiting
Children's Hospital of PhiladelphiaPhiladelphia, Pennsylvania, United StatesRecruiting
Cook Children's Health Care SystemFort Worth, Texas, United StatesRecruiting
University of Virginia Health SystemCharlottesville, Virginia, United StatesRecruiting
Instituto de Investigaciones MetabólicasBuenos Aires, Buenos Aires, ArgentinaRecruiting
Hospital de Niños de la Santísima TrinidadCórdoba, Córdoba Province, ArgentinaRecruiting
Hospital Italiano de Buenos AiresBuenos Aires, ArgentinaRecruiting
Instituto Médico Especializado (IME)Buenos Aires, ArgentinaRecruiting
CEDIE "Centro de Investigaciones Endocrinológicas", CONICET-FEI División de Endocrinología, Hosp de Niños Ricardo GutiérrezBuenos Aires, ArgentinaRecruiting
Institute of Endocrinology of Diabetes, The Children's Hospital at WestmeadWestmead, New South Wales, AustraliaWithdrawn
Queensland Children's HospitalSouth Brisbane, Queensland, AustraliaNot yet recruiting
Monash Children's Hospital, Monash HealthClayton, Victoria, AustraliaRecruiting
Perth Children's HospitalNedlands, Western Australia, AustraliaNot yet recruiting
UZA (Antwerp University Hospital)Edegem, Antwerp, BelgiumRecruiting
Cliniques Universitaires Saint-LucBrussels, Brussels Capital, BelgiumRecruiting
UZ Gent (University Hospital Ghent)Ghent, East Flanders, BelgiumRecruiting
UZ Leuven (Universitair Ziekenhuis Leuven)Leuven, Flemish Brabant, BelgiumRecruiting
Nucleo de Pesquisa Clinica do Rio Grande do SulPorto Alegre, Rio Grande do Sul, BrazilRecruiting
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São PauloRibeirão Preto, São Paulo, BrazilRecruiting
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP)São Paulo, São Paulo, BrazilRecruiting
Instituto de Investigaciones Materno Infantil IDIMI, Facultad de Medicina de la Universidad de ChileSantiago, Santiago Metropolitan, ChileRecruiting
Hospital las Hilgueras de TalcahuanoTalcahuano, ChileRecruiting
Centre Hospitalier Universitaire (CHU) d'AngersAngers, FranceRecruiting
Hopital Kremlin-Bicétre - APHP Paris SaclayLe Kremlin-Bicêtre, FranceRecruiting
Hopital Jeanne de Flandre - CHU de LilleLille, FranceRecruiting
APHM -Hopital La Timone EnfantsMarseille, FranceRecruiting
Hopital Necker - Enfants MaladesParis, FranceRecruiting
Hopital Robert DebreParis, FranceRecruiting
Universitätsklinikum Tübingen Klinik fur Kinder und JugendmedizinTübingen, Baden, GermanyRecruiting
Universitatsklinikum Koln Klinik und Poliklinik fur Kinder- und JugendmedizinCologne, North Rhine-Westphalia, GermanyRecruiting
Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum Klinik für pädiatrische Endokrinologie und DiabetologieBerlin, GermanyRecruiting
AOU Federico IINaples, Campania, ItalyRecruiting
IRCCS Istituto Giannina GasliniGenoa, Liguria, ItalyRecruiting
IRCCS Ospedale San RaffaeleMilan, Lombardy, ItalyRecruiting
Azienda Ospedaliera Universitaria Meyer IRCCSFlorence, Tuscany, ItalyRecruiting
Radboudumc Amalia Children's Hospital, Department of PediatricsNijmegen, Gelderland, NetherlandsRecruiting
Uniwersytecki Szpital Kliniczny im, Jana Mikulicza-Radeckiego we Wrocławiu, Klinika Pediatrii, Endokrynologii, Diabetologii i Chorób MetabolicznychWroclaw, Lower Silesian Voivodeship, PolandRecruiting
Uniwersytecki Dziecięcy Szpital Kliniczny im. L. Zamenhofa w Białymstoku, Klinika Pediatrii, Endokrynologii, Diabetologii z Pododdziałem KardiologiiBialystok, Podlaskie Voivodeship, PolandRecruiting
lnstytut Centrum Zdrowia Matki Polki, Klinika Endokrynologii i Chor6b MetabolicznychLodz, Poland, PolandRecruiting
Uniwersytecki Szpital Kliniczny Nr 1 im. Prof. Tadeusza Sokotowskiego PUM w Szczecinie, Centrum Wsparcia Badan Klinicznych Pomorskiego Uniwersytetu Medycznego w SzczecinieSzczecin, West Pomeranian Voivodeship, PolandRecruiting
King Faisal Specialist Hospital & Research CenterRiyadh, Saudi ArabiaRecruiting
King Saud University Medical City (KSU-MC}Riyadh, Saudi ArabiaRecruiting
Alder Hey Children's NHS Foundation Trust, Alder Hey Children's HospitalLiverpool, United KingdomRecruiting
Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street HospitalLondon, United KingdomRecruiting
Manchester University NHS Foundation Trust, Royal Manchester Children's HospitalManchester, United KingdomRecruiting
Sheffield Children's Hospital NHS Trust, Sheffield Children's Hospital, Western BankSheffield, United KingdomRecruiting
Study team and timeline
- Lead sponsor
- Crinetics Pharmaceuticals Inc.
- Study start
- Jan 22, 2026 Actual
- Primary completion
- 2030-03 Estimated
- Study completion
- 2030-03 Estimated
- First posted
- Sep 8, 2025 Actual
- Last updated
- Nov 10, 2026 Actual
Official study contacts
Official study title
A Phase 2/3 Study to Evaluate the Safety, Efficacy, and Pharmacokinetics of Atumelnant Treatment in Pediatric Participants With Congenital Adrenal Hyperplasia Including a Long-Term Extension
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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026
