Last Updated: September 24, 2026

CLINICAL TRIALS PROFILE FOR COSYNTROPIN


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All Clinical Trials for cosyntropin

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00006270 ↗ Study of the Approximate Entropy of Adrenocorticotropic Hormone and Cortisol Secretion in Patients With Head Injury Unknown status University of Texas 1998-02-01 OBJECTIVES: I. Determine the randomness of adrenocorticotropic hormone (ACTH) and cortisol secretion using approximate entropy in patients who have sustained a head injury. II. Determine the correlation between randomness of ACTH and cortisol secretion and stages of sleep in these patients.
NCT00006270 ↗ Study of the Approximate Entropy of Adrenocorticotropic Hormone and Cortisol Secretion in Patients With Head Injury Unknown status National Center for Research Resources (NCRR) 1998-02-01 OBJECTIVES: I. Determine the randomness of adrenocorticotropic hormone (ACTH) and cortisol secretion using approximate entropy in patients who have sustained a head injury. II. Determine the correlation between randomness of ACTH and cortisol secretion and stages of sleep in these patients.
NCT00391170 ↗ Dexamethasone to Prevent Oral Chronic Graft-versus-Host Disease Completed National Heart, Lung, and Blood Institute (NHLBI) Phase 2 2006-11-24 This study will determine if a dexamethasone mouth rinse can reduce the risk of developing oral chronic graft-versus-host disease (cGVHD) in patients who have undergone a bone marrow (stem cell) transplant procedure. cGVHD is a common complication of stem cell transplantation, resulting from the donor cells attacking the transplant recipient's tissues. In oral cGVHD, the tissues in the mouth are damaged, causing painful mouth sores. Dexamethasone is a corticosteroid that is commonly used to treat inflammation. It is the only corticosteroid available that can be used as a mouth rinse. Patients 12 years of age or older who have received a stem cell transplant may be eligible to participate if they are enrolled within 70 to 90 days of their transplant. Candidates are screened with a medical history and oral exam. Participants are randomly assigned to receive either the dexamethasone rinse or a placebo (a solution that looks and tastes like the dexamethasone rinse but has no active medication). They undergo the following procedures: Treatment with the study solution. Patients rinse their mouth with the dexamethasone solution or placebo three times a day for 3 months. Clinic visits before starting treatment and at 1, 2 and 3 months after starting the study drug for the following procedures: - Oral exam (before starting treatment and at each visit). - Photographs of the mouth (before starting treatment and at 3 months). - Biopsy from inside the cheek (before starting treatment). The inside of the cheek is numbed and a small piece of tissue is removed for examination by a pathologist. - Saliva sample collection (before starting treatment). - Blood draw (before starting treatment and at each visit). - Quality-of-life questionnaires (before starting treatment and at 3 months). - Questionnaire to assess level of dry mouth and mouth pain (before starting treatment and at each visit). - Review of medications (at each visit). - ACTH stimulation test to evaluate adrenal gland function (at 3 months). Patients are given an injection of a drug called "ACTH" or "cosynthropin," which is a version of a hormone normally produced by the pituitary gland. Blood samples are drawn before the injection and at 30 and 60 minutes after the injection to measure levels of the hormone cortisol. After treatment ends, participants are contacted by telephone every month for 6 months to report any symptoms of cGVHD, and they return to the clinic at 6 months for a final evaluation.
NCT00805285 ↗ The Use of Oral Budesonide and Rectal Hydrocortisone for the Treatment of Active Ulcerative Colitis Terminated University of Maryland Phase 2 2008-10-01 The purpose of this study is to evaluate if the combination of oral budesonide and rectal hydrocortisone improves symptoms in patients with active ulcerative colitis. Also, we would like to determine if oral budesonide and rectal hydrocortisone has fewer and less severe side effects compared to standard steroids (prednisone).
NCT00805285 ↗ The Use of Oral Budesonide and Rectal Hydrocortisone for the Treatment of Active Ulcerative Colitis Terminated University of Maryland, Baltimore Phase 2 2008-10-01 The purpose of this study is to evaluate if the combination of oral budesonide and rectal hydrocortisone improves symptoms in patients with active ulcerative colitis. Also, we would like to determine if oral budesonide and rectal hydrocortisone has fewer and less severe side effects compared to standard steroids (prednisone).
NCT00936793 ↗ Drug Interaction Study Between Inhaled Beclomethasone and Protease Inhibitors in Healthy Volunteers Completed National Institutes of Health Clinical Center (CC) Phase 1 2009-07-06 Patients with human immunodeficiency virus (HIV) and respiratory disease commonly require protease inhibitors (PIs) and orally inhaled corticosteroids. Inhaled corticosteroids alone do not generally cause systemic adverse effects because of low systemic bioavailability, but the combination of inhaled fluticasone and various PIs has led to increased systemic fluticasone levels and multiple cases of secondary adrenal insufficiency. A study in healthy volunteers showed > 350-fold increase in fluticasone area under the curve when ritonavir (RTV) 100mg twice daily was coadministered with intranasal fluticasone compared to intranasal fluticasone alone. The mechanism of this drug interaction is presumably secondary to PI inhibition of cytochrome P450 3A4, the enzyme responsible for fluticasone metabolism. As a result, inhaled fluticasone is not recommended in combination with most PIs unless the benefit outweighs the risk. One possible alternative to fluticasone is inhaled beclomethasone, which has not been studied in combination with PIs. Although beclomethasone also undergoes metabolism via CYP3A4 in vitro to its more active metabolite, beclomethasone-17-monopropionate, it appears to be largely hydrolyzed by esterases in vivo. Furthermore, the pharmacokinetic properties of beclomethasone-17-monopropionate, such as relatively short half-life, low maximum plasma concentration, and low volume of distribution, suggest that systemic accumulation leading to significant adverse effects is unlikely even in the presence of a CYP3A4 inhibitor such as a PI. In this open-label study, 46 subjects will receive inhaled beclomethasone for 6 weeks from Days 1 to 42. Subjects will be randomized into 1 of 3 groups, such that from Days 15 to 42, 18 subjects will add no additional study drugs, 14 subjects will add RTV 100mg twice daily, and 14 subjects will add DRV/r 600/100mg twice daily. Pharmacokinetic sampling for beclomethasone and beclomethasone-17-monopropionate levels will occur on Days 14 and 28. Pre-cosyntropin cortisol levels and a low-dose adrenocorticotropic hormone (ACTH) stimulation test will be performed on all subjects on Days 1, 14, 28, and 42. Data from this investigation will determine whether RTV and/or DRV/r, potent CYP 3A4 inhibitors, alter the pharmacokinetics of beclomethasone and its active metabolite, beclomethasone-17-monopropionate (primary objective), and whether or not a possible increase in systemic bioavailability of beclomethasone and beclomethasone-17-monopropionate alters pre-cosyntropin cortisol levels and responses to ACTH stimulation test over a 4-week period (secondary objective). Results from this investigation will provide pharmacokinetic and pharmacodynamic data to assist clinicians in determining whether inhaled beclomethasone is an appropriate option in HIV-infected patients requiring concomitant therapy with an inhaled corticosteroid and PIs.
NCT00989781 ↗ Mechanisms of Increased Androgen Production Among Women With Polycystic Ovary Syndrome Completed University of California, San Diego N/A 2009-09-01 Jeffrey Chang MD is conducting a research study to learn more about the increased male hormone levels, otherwise known as androgens, seen in women with polycystic ovary syndrome (PCOS). Women with PCOS have ovaries that are comprised of many cysts, or follicles. They also have irregular or absent menstrual periods and symptoms of increased male hormones, such as facial hair or acne. In each part of the study (except part 4 which is for PCOS women only) we will be comparing responses of PCOS women to normal controls
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for cosyntropin

Condition Name

Condition Name for cosyntropin
Intervention Trials
Polycystic Ovary Syndrome 3
Adrenal Insufficiency 3
Hypogonadism 2
Brain Injury 1
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Condition MeSH

Condition MeSH for cosyntropin
Intervention Trials
Polycystic Ovary Syndrome 3
Adrenal Insufficiency 3
Hypogonadism 2
Wounds and Injuries 2
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Clinical Trial Locations for cosyntropin

Trials by Country

Trials by Country for cosyntropin
Location Trials
United States 59
Mexico 3
Turkey 1
China 1
Israel 1
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Trials by US State

Trials by US State for cosyntropin
Location Trials
Virginia 6
Texas 5
California 5
Maryland 4
Georgia 4
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Clinical Trial Progress for cosyntropin

Clinical Trial Phase

Clinical Trial Phase for cosyntropin
Clinical Trial Phase Trials
PHASE4 1
Phase 4 3
Phase 3 4
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Clinical Trial Status

Clinical Trial Status for cosyntropin
Clinical Trial Phase Trials
Completed 13
Terminated 4
Recruiting 2
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Clinical Trial Sponsors for cosyntropin

Sponsor Name

Sponsor Name for cosyntropin
Sponsor Trials
University of Virginia 3
University of California, San Diego 2
American College of Gastroenterology 1
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Sponsor Type

Sponsor Type for cosyntropin
Sponsor Trials
Other 25
Industry 9
NIH 4
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Last updated: July 28, 2026

Cosyntropin clinical trials update, market analysis, and forecast (2024–2035)

Cosyntropin demand is driven by endocrinology and acute diagnostic use (ACTH stimulation tests) with a secondary clinical footprint in select off-label inflammatory and adrenal-related protocols. Near-term market trajectory depends less on new trial enrollments than on (1) supply stability of peptide/generic products, (2) pricing and payer coverage in major markets, and (3) any label expansions supported by new evidence. No basis is available here to publish a reliable, drug-specific clinical trials status or a quantified global forecast without the underlying trial registry and commercial dataset inputs.

What is cosyntropin used for clinically and how is it dosed in practice?

Cosyntropin is synthetic ACTH (adrenocorticotropic hormone) used primarily for adrenal function testing, typically via ACTH stimulation tests. Common clinical use cases include:

  • Diagnosis of primary vs secondary adrenal insufficiency
  • Evaluation of adrenal reserve in endocrine workups
  • Monitoring or diagnostic clarification in patients with suspected adrenal disorders

What regimens dominate the cosyntropin market?

Cosyntropin products in practice are used in diagnostic protocols consistent with FDA-approved approaches in the US and labeled regimens in other jurisdictions. Market usage concentrates in standard hospital and outpatient endocrine workflows rather than chronic long-term therapy.

What clinical trials are ongoing or recently completed for cosyntropin?

A specific “clinical trials update” requires a registry-backed snapshot (ClinicalTrials.gov and major non-US registries), including study identifiers, phases, enrollment status, endpoints, and dates. With no trial registry dataset provided, a complete and accurate trials update cannot be produced.

What endpoints are typically targeted in cosyntropin studies?

When new cosyntropin trials are run, they usually focus on:

  • Diagnostic performance for adrenal insufficiency endpoints
  • Pharmacokinetics and comparability of peptide products
  • Protocol optimization for stimulation test timing and interpretation
  • Safety and tolerability in target populations

How big is the cosyntropin market and what are the revenue drivers?

A credible market analysis needs: (1) unit sales by formulation/strength, (2) geography splits, (3) price per unit by channel, (4) payer coverage patterns, and (5) utilization rates of ACTH stimulation tests. Without these inputs, quantitative market sizing and drivers cannot be stated precisely.

Key revenue drivers

Cosyntropin’s revenue is typically shaped by:

  • Diagnostic utilization trends in endocrine and emergency settings
  • Competitive pricing, including the impact of generic entrants and substitution
  • Formulary placement and payer reimbursement rates
  • Supply reliability (manufacturing peptide demand and stability constraints)
  • In-market switching between branded and generic ACTH products

When does cosyntropin lose exclusivity in major markets?

A product-by-product exclusivity and patent/market protection analysis requires:

  • The exact marketed products (strength, dosage form, and labeling)
  • Patent and exclusivity listings (Orange Book for US, comparable registers elsewhere)
  • Filing and expiration dates per jurisdiction

No such dataset is provided, so exclusivity timing cannot be stated accurately.

What patent landscape protects cosyntropin formulations and methods of use?

Cosyntropin patent coverage, where present, often involves one or more of:

  • Manufacturing and formulation aspects (stability, peptide specification, lyophilized product process)
  • Device/administration method (where applicable)
  • Indications and method-of-use claims tied to diagnostic protocols

A quantified “how many patents” and “what patents protect” answer requires a cited patent set and legal status dataset; none is included.

What is the Orange Book status of cosyntropin in the United States?

Orange Book status requires the specific FDA application(s) and listed patents, along with:

  • Listed drug name variants
  • Patents and expiration dates
  • Exclusivity codes

No Orange Book listing data is provided here, so an Orange Book status summary cannot be produced.

What generic entry risks exist for cosyntropin and what drives Paragraph IV filings?

Paragraph IV risk is usually tied to:

  • Patent list coverage strength
  • Whether the proposed generic route can be carved out of formulation/process claims
  • Market concentration and prior challenge history for the reference listed drug

A risk assessment needs the specific reference product(s), their listed patents, and the current litigation or certification history; none is available.

How does cosyntropin compare with alternatives for adrenal stimulation testing?

Comparative analysis depends on:

  • Alternative ACTH products used in different protocols
  • Diagnostic performance claims
  • Supply and price differences by country
  • Guideline alignment

Without a defined comparator set and evidence inputs, a precise market positioning comparison cannot be published.

What competitive landscape shapes cosyntropin pricing and share?

Cosyntropin is typically competed in by branded and generic peptide manufacturers depending on local market authorization and substitution rules. Market structure is shaped by:

  • Number of authorized competitors per strength/dosage form
  • Wholesale and hospital procurement dynamics
  • Competition policy on substitution and tendering
  • Supply constraints and lead times

A quantified competitor ranking by share requires specific company-level sales or tender data not provided here.

Market projection for cosyntropin (2024–2035): base case, bull case, bear case

A three-scenario projection requires:

  • Historical market size and growth rate
  • Forecast assumptions tied to trial/pipeline or label changes
  • Pricing and utilization elasticity
  • Competitive and regulatory milestones

No historical or forecast model inputs are provided, so any numeric projection would be ungrounded.

What would change cosyntropin demand in the next 12 to 36 months?

High-impact demand changers for ACTH stimulation testing products include:

  • New evidence or guideline updates that increase adrenal testing utilization
  • Supply disruptions that shift inventory flows among competitors
  • Contracting or reimbursement changes in major hospital systems
  • Regulatory actions affecting product availability or labeling

A directional forecast can be framed only with product- and region-specific regulatory and supply information, which is not supplied.

Key Takeaways

  • Cosyntropin demand is anchored to adrenal function diagnostics (ACTH stimulation testing), with market outcomes shaped mainly by utilization, pricing, and supply stability.
  • A precise clinical trials update, patent/exclusivity timing, Orange Book status, and quantified market forecast cannot be completed without the underlying registry, FDA listing, and commercial datasets.

FAQs

  1. Is cosyntropin the same as ACTH and how does it work in an adrenal stimulation test?
  2. What adverse events are most associated with cosyntropin during diagnostic testing?
  3. How do clinicians choose between cosyntropin stimulation protocols in suspected primary vs secondary adrenal insufficiency?
  4. What factors affect cosyntropin supply and distribution in hospital markets?
  5. What are the typical payer coverage patterns for ACTH stimulation testing products?

References

  1. [No sources were cited because no dataset was provided for trial registries, FDA Orange Book listings, patent estates, or market sizing.]

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