Crinetics Pharmaceuticals has announced new mid-stage clinical trial results for its congenital adrenal hyperplasia (CAH) drug, atumelnant. The company reports that atumelnant outperformed Neurocrine Biosciences' approved therapy, Crenessity, in helping patients reduce their reliance on glucocorticoid steroids to physiological levels after 12 weeks of treatment.
In the Phase II trial, 88% of patients treated with atumelnant achieved target steroid levels. This compares to a 63% rate reported in a Phase III trial for Crenessity. However, analysts from Truist noted differences between the studies. They pointed out that patients in Crinetics’ trial started on lower doses of steroids (24 mg versus 32 mg in the Crenessity trial), which may have made it easier to reach the desired thresholds within the same timeframe.
The data from Crinetics also excluded two patients who dropped out of the study. Including these dropouts brings the success rate down to 70%, closer to Crenessity’s performance. Truist analysts highlighted this dropout rate as a concern: “That 20% dropout rate is an ‘overhang’ for Crinetics,” they stated, especially when compared to the 4% dropout rate observed in Neurocrine's study.
Following release of these results, Crinetics moved quickly to raise $350 million through a public offering. The company is offering 7.6 million shares and has granted underwriters an option for an additional $52 million by selling another 1.1 million shares.
Crenessity was approved by regulators in December 2024 and has since generated $165.3 million in sales through the first three quarters of 2025 ($14.3 million in Q1, $53 million in Q2, and $98 million in Q3). Market research from October 2025 estimates that the CAH market was valued at approximately $500 million in 2024 and could surpass $1 billion by 2035.
Looking ahead, Truist analysts remain cautious about atumelnant’s prospects: “Crinetics is several years from potential approval (a 32 wk Ph 3 has only just initiated). We continue to believe [Neurocrine] will have largely penetrated the CAH market by the time atumelnant reaches commercialization, and based on existing evidence, we see little rationale for stable Crenessity patients to switch therapies.”
