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Congenital Adrenal HyperplasiaPhase 3CONnECTNCT05063994

Comparison of Chronocort Versus Standard Hydrocortisone Replacement Therapy in Participants Aged 16 Years and Over With Congenital Adrenal Hyperplasia

A Phase 3 study testing Chronocort and Cortef in people with Congenital Adrenal Hyperplasia, run by Neurocrine UK Limited at 21 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is a randomized, double-blind, active-controlled, phase III study of Chronocort® compared with immediate-release hydrocortisone replacement therapy in participants aged 16 years and over with Congenital Adrenal Hyperplasia. Read more about this study

Who is it for?
Ages 16 years and older
Conditions the study is for
Congenital Adrenal Hyperplasia
What is being tested?
Chronocort and Cortef
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
55 participants
Where
21 sitesin 3 countries
Study dates
24 May 2022to 2 Feb 2024
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female participants must be aged 16 years or older at the time of signing the informed consent/assent.
  • In participants aged <18 years, height velocity must be less than 2 cm/year in the last year and puberty must be completed (Tanner stage V).
  • Participants with known classic CAH due to 21 hydroxylase deficiency diagnosed in childhood with documented (at any time) elevated 17-OHP and with or without elevated A4 and currently treated with hydrocortisone, prednisone, prednisolone or dexamethasone (or a combination of the aforementioned glucocorticoids) and on stable glucocorticoid therapy for a minimum of 3 months.
  • Participants who are receiving fludrocortisone must be on a documented stable dose for a minimum of 3 months prior to enrollment and must have stable renin levels at screening.
  • Female participants of childbearing potential and all male participants must agree to the use of an accepted method of contraception during the study.
  • A female participant is eligible to participate if she is not pregnant, not breastfeeding, and she is either not a woman of childbearing potential (WOCBP) or has a negative pregnancy test at entry into the study. Note: females presenting with oligomenorrhea or amenorrhea who are aged ≤55 years should be considered potentially fertile and therefore should undergo pregnancy testing like all other female participants.
  • Capable of giving signed informed consent/assent which includes compliance with requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Who cannot join

  • Clinical or biochemical evidence of hepatic or renal disease e.g. creatinine >2 times the upper limit of normal (ULN) or elevated liver function tests (alanine aminotransferase [ALT] or aspartate aminotransferase [AST] >2 times the ULN).
  • History of bilateral adrenalectomy.
  • History of malignancy (other than basal cell carcinoma successfully treated >26 weeks prior to entry into the study).
  • Participants who have type 1 diabetes or receive regular insulin, have uncontrolled diabetes, or have a screening HbA1c greater than 8%.
  • Persistent signs of adrenal insufficiency or the participant does not tolerate treatment at the end of the 4-week run-in period.
  • Participants with any other significant medical or psychiatric conditions that in the opinion of the Investigator would preclude participation in the study.
Show all 18Show fewer
  • Participants on regular daily inhaled, topical, nasal or oral steroids for any indication other than CAH.
  • Co-morbid condition requiring daily administration of a medication or consumption of any material that interferes with the metabolism of glucocorticoids.
  • Participants who are receiving <10 mg hydrocortisone dose at screening or the hydrocortisone dose equivalent.
  • Participants anticipating regular prophylactic use of additional steroids e.g. for strenuous exercise.
  • Participation in another clinical study of an investigational or licensed drug or device within the 12 weeks prior to screening.
  • Inclusion in any natural history or translational research study that would require evaluation of androgen levels during the study period outside of this protocol's assessments.
  • Participants who have previously been exposed to Chronocort in any Diurnal study.
  • Participants who routinely work night shifts and so do not sleep during the usual night-time hours.
  • Participants, who in the opinion of the Investigator, will be unable to comply with the requirements of the protocol.
  • Participants with a known hypersensitivity to any of the components of the Chronocort capsules, the Cortef tablets, or the placebo capsules.
  • Participants with congenital galactosemia, malabsorption of glucose and galactose, or who are lactase deficient.
  • Participants with a body weight of 45 kg or less.

Trial locations and contacts

21 sites in 3 countries.

21 sites in 3 countries

United States11 sites
  • Diurnal Investigational Site in Michigan

    Ann Arbor, Michigan, 48109

  • Diurnal Investigational Site in Maryland

    Bethesda, Maryland, 20892-1932

  • Diurnal Investigational Site in Dallas

    Dallas, Texas, 75235

  • Diurnal Investigational Site in Iowa

    Iowa City, Iowa, 52224

  • Diurnal Investigational Site in Jacksonville

    Jacksonville, Florida, 32207

  • Diurnal Investigational Site in Nevada

    Las Vegas, Nevada, 89148

  • Diurnal Investigational Site in Los Angeles

    Los Angeles, California, 90027

  • Diurnal Investigational Site in Milwaukee

    Milwaukee, Wisconsin, 53226

  • Diurnal Investigational Site in Orange

    Orange, California, 92868

  • Diurnal Investigational Site in Rochester

    Rochester, Minnesota, 55901

  • Diurnal Investigational Site in Seattle

    Seattle, Washington, 98105

Other trials in United States

France6 sites
  • Diurnal Investigational Site in Pessac

    Bordeaux, 33604

  • Diurnal Investigational Site in Caen

    Caen, Normandy, 14033

  • Diurnal Investigational Site in Bron

    Lyon, 69677

  • Diurnal Investigational Site in Paris

    Paris, 75651

  • Diurnal Investigational Site in Toulouse (Children's Hospital)

    Toulouse, 31059

  • Diurnal Investigational Site in Toulouse

    Toulouse, 31059

Other trials in France

Japan4 sites
  • Diurnal Investigational Site in Yushima

    Bunkyō-Ku, Tokyo, 113-8519

  • Diurnal Investigational Site in Okura

    Setagaya-Ku, Tokyo, 157-8535

  • Diurnal Investigational Site in Toyama

    Shinjuku-Ku, Tokyo, 162-8655

  • Diurnal Investigational Site in Asahi-ku

    Yokohama, Kanagawa, 241-0811

Other trials in Japan

About this study

Official title: A Randomized, Double-Blind, Active-Controlled, Phase 3 Study of Chronocort Compared With Immediate-Release Hydrocortisone Replacement Therapy in Participants Aged 16 Years and Over With Congenital Adrenal Hyperplasia

This study is a randomized, double-blind, active-controlled, phase III study of Chronocort® compared with immediate-release hydrocortisone replacement therapy in participants aged 16 years and over with Congenital Adrenal Hyperplasia.

Read the detailed description

The study will compare the efficacy, safety and tolerability of twice daily Chronocort with twice daily immediate release hydrocortisone replacement therapy (IRHC) (Cortef®) in participants aged 16 years and over with known classic Congenital Adrenal Hyperplasia (CAH) due to 21 hydroxylase deficiency.

Being tested
Chronocort, Cortef, Placebo
Medical subject headings
Adrenal Hyperplasia, Congenital

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ChronocortDrug

    Also called Hydrocortisone modified-release

    Over-encapsulated hydrocortisone modified-release capsule for oral administration.

  • CortefDrug

    Also called Immediate-release hydrocortisone, IRHC

    Over-encapsulated hydrocortisone immediate-release tablet for oral administration.

  • PlaceboOther

    Matching placebo

Study groups in NCT05063994
Study groupRoleWhat they receive
ChronocortExperimentalParticipants received Chronocort at a starting dose of 30 milligrams (mg), with dose adjustments down to 25, 20, or 15 mg based on adrenal insufficiency symptoms and androgen levels. Placebo was used for dose adjustment to maintain blinding.
Receives: Drug: Chronocort; Other: Placebo
CortefActive comparatorParticipants received Cortef at a starting dose of 30 mg, with dose adjustments down to 25, 20, or 15 mg based on adrenal insufficiency symptoms and androgen levels. Placebo was used for dose adjustment to maintain blinding.
Receives: Drug: Cortef; Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Who Were Biochemical Responders at Week 28

    Biochemical response was defined as a participant who a) was in biochemical control at the 08:00 assessment and b) was receiving a total daily dose of hydrocortisone of not more than 25 mg if the participant was in biochemical control at baseline or not more than 30 mg if the participant was not in biochemical control at baseline.

    Biochemical control was defined as both a 17-OHP concentration equal to or below the upper limit for optimal control (1200 ng/dL [36.4 nmol/L]) and an A4 concentration equal to or below the upper limit of the reference range (150 ng/dL [5.2 nmol/L] for men and 200 ng/dL [7.0 nmol/L] for women).

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Week 28

Secondary outcomes (14)
  1. Percentage of Participants Who Were Dose Responders at Week 28

    Dose response was defined as a participant who a) was receiving a total daily dose of hydrocortisone of not more than 25 mg and b) was in biochemical control at the 08:00 assessment.

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Week 28

  2. Total Daily Dose of Hydrocortisone at Week 28

    Least squares (LS) mean was assessed using mixed model repeated measures (MMRM).

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Week 28

  3. Number of Participants in Biochemical Control

    Biochemical control was defined as both a 17-OHP concentration (assessed at 08:00) equal to or below the upper limit for optimal control (1200 ng/dL [36.4 nmol/L]) and an A4 concentration equal to or below the upper limit of the reference range (150 ng/dL [5.2 nmol/L] for men and 200 ng/dL [7.0 nmol/L] for women).

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline and Week 28

  4. Change From Baseline in Mean of 08:00 and 13:00 17-OHP Levels at Week 28

    LS mean was assessed using analysis of covariance (ANCOVA). Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  5. Change From Baseline in Mean of 08:00 and 13:00 A4 Levels at Week 28

    LS mean was assessed using ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  6. Number of Participants With Menstrual Regularity (Females of Childbearing Potential Only) at Week 28

    Data are presented for the number of participants with more than monthly menstrual cycles, monthly menstrual cycles, and number of participants with oligomenorrhoea and amenorrhoea. Oligomenorrhoea was defined as fewer than 9 menstrual cycles per year or cycle length >35 days and amenorrhoea as absent menses for ≥ 3 months.

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Week 28

  7. Change From Baseline in Luteinizing Hormone Levels (Males Only) at Week 28

    LS mean was assessed using ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  8. Percent Change From Baseline in Size of Testicular Adrenal Rest Tumors at Week 28 (Males Only)

    Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Week 28

  9. Change From Baseline in Hirsutism at Week 28 Using the Ferriman-Gallwey Score (Females Only) at Week 28

    Ferriman-Gallwey score is a method used to assess and quantify hirsutism in women. A total score < 8 is considered normal whereas a score of 8 to 15 indicates mild hirsutism. A score >15 indicates moderate or severe hirsutism. The Ferriman-Gallwey score ranged from 0 to 36. Higher score indicated more hirsutism. Change from baseline is reported (negative change from baseline indicated improvement).

    LS mean was assessed using ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  10. Change From Baseline in Acne Using the Global Evaluation Acne (GEA) Scale (Females Only) at Week 28

    Acne severity was assessed according to GEA scale, which ranged from 0 (Clear. No lesions) to 5 (Very severe). Higher score indicated higher severity of acne. Change from baseline is reported (negative change from baseline indicated improvement).

    LS mean was assessed using ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  11. Change From Baseline in Glycated Hemoglobin (HbA1c) Percent Levels at Week 28

    LS mean was assessed by ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  12. Change From Baseline in Waist Circumference at Week 28

    LS mean was assessed using ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  13. Change From Baseline in Body Weight at Week 28

    LS mean was assessed by ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

  14. Change From Baseline Quality of Life Using the Self-completed Medical Outcome Study 36-Item Short Form Health Survey (SF-36) Total Score for the Physical and Mental Components and the Sub-domain of Vitality at Week 28

    SF-36 evaluates aspects of functional health and well-being. The physical component has 4 sub-scales: physical function, role limitations due to physical problems, pain, and general health perception; and the mental component has 4 sub-scales: vitality, social function, role limitations due to emotional problems, and mental health. Total scores for the physical and mental component are presented as well as the sub-scale score for vitality. Scores were summarized and transformed into a range from 0 to 100; 0=worst, and 100=best outcome. Higher scores indicated better outcome. Change from baseline is reported (positive change from baseline indicated improvement).

    LS mean was assessed by ANCOVA. Assessment of efficacy at Week 28 was a composite of each participant's on-treatment visit closest in time to 28 weeks post randomization.

    Measured: Baseline, Week 28

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Oct 2021
  2. Study start24 May 2022
  3. Primary completion2 Feb 2024
  4. Study completion2 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
55 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05063994
Sponsor's protocol ID
DIUR-014
Acronym
CONnECT
Status last verified
Sep 2026
First submitted
28 May 2021
Last updated
2 Oct 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Chronocort and Cortef in people with Congenital Adrenal Hyperplasia, run by Neurocrine UK Limited at 21 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in United States, France, Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 Feb 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Who Were Biochemical Responders at Week 28 (time frame: Week 28). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2026.

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