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先天性副腎過形成症(CAH)は、世界中でおよそ400,000人の患者さんがいます。CAHに対する現在の治療では、標準的な治療レジメンはなく、さまざまな汎用グルココルチコイドステロイド(米国ではヒドロコルチゾン、デキサメタゾン、プレドニゾロン、プレドニゾンなど)が使用されています。The cortisol deficiency and over-production of male sex hormones caused by CAH can lead to increased mortality, infertility, and sexual development issues. Sufferers, even if treated, remain at risk of death from an adrenal crisis.

In July 2021, the European Commission (EC) approved the marketing authorization for Efmody® (hydrocortisone modified-release hard capsules – development name Chronocort®) to treat adult and adolescent patients (12 years and older) with CAH. Efmody contains the active substance hydrocortisone and is a hybrid medicine, meaning it has a different use and is available in different strengths as capsules formulated to release the active substance over a prolonged period (modified release).

To facilitate clinical development, Certara scientists used the Simcyp Simulator to perform physiologically-based pharmacokinetic (PBPK) modeling and simulation for the endogenous hormone cortisol (hydrocortisone) in healthy adults and children and adults with adrenal insufficiency. The model predicted immediate-release hydrocortisone pharmacokinetics in adults across the dose range. The model also accurately predicted pharmacokinetic parameters for modified-release formulations after single and multiple dosing. Predicted modified-release formulation pharmacokinetics (PK) in 12 to 18-year-olds was like adults.

PBPK assisted in determining the final dosing regimen for CAH treatment with Chronocort.

CAH is an orphan condition caused by deficiency of adrenal enzymes needed to produce the steroid hormone cortisol. The block in the cortisol production pathway causes over-production of androgen precursors to cortisol. The condition is congenital and affects both sexes.

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