Crinecerfont for Steroid Reduction in CAH

This episode evaluates crinecerfont, an oral corticotropin-releasing factor type 1 receptor antagonist, for classic congenital adrenal hyperplasia. By blocking pituitary ACTH secretion independently of glucocorticoid feedback, crinecerfont reduces adrenal androgen excess, including androstenedione. This mechanism permits significant supraphysiologic glucocorticoid dose reduction toward physiologic replacement levels, mitigating long-term iatrogenic metabolic and skeletal complications while preserving adrenal control.