THE COMPLICATIONS OF TREATING CAH
WITH GCs ALONE

Treating CAH
with GCs
alone
creates a
tug-of-war
between androgen
levels and GC
comorbidities¹

Clinical management aims to balance the hormonal deficiency of cortisol and aldosterone while controlling the overproduction of adrenal androgens.¹

Many pediatric and adult patients with CAH treated with GCs alone have androstenedione levels that are not optimal²

~2/3

of patients with CAH treated solely with GCs have suboptimal androgen levels^1-3

Androstenedione
levels²*

Androstenedione levels in adults with CAH bar graph

Androstenedione levels in children with CAH bar graph

Adapted from Finkielstain GP et al. Clinical characteristics of a cohort of 244 patients with congenital adrenal hyperplasia. J Clin Endocrinol Metab. 2012;97(12):4429-4438. doi:10.1210/jc.2012-2102. Reproduced by permission of Oxford University Press on behalf of the Endocrine Society. https://academic.oup.com/jcem/article/97/12/4429/2536442

Median age of patients was 33 years.
GC=glucocorticoid.

This study included patients from all regions of the US²:

Majority of children were on hydrocortisone (15.0 ± 5.9 mg/m²/day)
Adults were taking either hydrocortisone, prednisone, or dexamethasone (17.9 ± 7.6 mg/m²/day)

*Suppressed, normal, and elevated levels are determined by age- and sex-specific normal ranges.

NEARLY 1/3 OF ADULT PATIENTS WITH CAH TAKING GCs ALONE TO MANAGE ANDROGENS are treated for ≥1 comorbidity^†

In a multicenter study, 73 of 244 CAH patients taking GCs alone (median age: 33 years) were treated for ≥1 of the assessed cardiometabolic and bone comorbidities.⁴

~1/3

of adults with CAH taking GCs alone are treated for ≥1 cardiometabolic or bone comorbidity^4†

Chart showning comorbidity rates in CAH patients taking GCs: osteoporosis and osteopenia, hyperlipidemia, type 2 diabetes, hypertension

^†Osteoporosis incidence among young adults (aged 20-44) was estimated at 4.1 per 100,000 person-years in a Mayo Clinic study, and >50% of those cases were induced. The prevalence of dyslipidemia, diabetes, and hypertension among young adults (aged 18-44) is 37%, 4%, and 10% respectively, based on a recent study using National Health and Nutrition Examination Survey (NHANES) data. Neither of these studies reports rates of treatment for these conditions.^5,6

Explore the Potential of the CRF Pathway in ACTH and androgen management¹

THE COMPLICATIONS OF TREATING CAH WITH GCs ALONE

Treating CAH with GCs alone creates a tug-of-war between androgen levels and GC comorbidities1

Many pediatric and adult patients with CAH treated with GCs alone have androstenedione levels that are not optimal2