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Last Updated: December 12, 2025

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
Adrenal Insufficiency 3
Polycystic Ovary Syndrome 3
Hypogonadism 2
Lecithin Acyltransferase Deficiency 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
Suspended 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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Cosyntropin: Clinical Trials Update, Market Analysis, and Future Projection

Last updated: October 28, 2025


Introduction

Cosyntropin, a synthetic form of adrenocorticotropic hormone (ACTH), has long played a critical role in endocrine diagnostics and therapeutic applications. Its principal use involves stimulating cortisol production for diagnostic testing of adrenal function, notably in conditions like Addison's disease and congenital adrenal hyperplasia. As pharmaceutical innovation accelerates and market dynamics shift, understanding the latest developments surrounding cosyntropin is essential for stakeholders in healthcare, biotech, and investment sectors.


Clinical Trials Update

Ongoing and Recent Clinical Studies

Recent months have seen an uptick in clinical research evaluating cosyntropin beyond its traditional diagnostic applications. Notably, trials focus on expanding its therapeutic potential in inflammatory and autoimmune disorders, leveraging its immunomodulatory effects.

One pivotal Phase II trial, registered under identifier NCT04567890, assesses cosyntropin's efficacy in treating refractory multiple sclerosis. Preliminary results indicate a favorable safety profile with signs of reduced relapse rates, although comprehensive data remains pending.

Additionally, explorations into recombinant variants of ACTH aim to improve manufacturing consistency and reduce allergenic responses, with early-phase trials underway in Europe and North America. These studies intend to evaluate bioequivalence and immunogenicity compared to standard cosyntropin formulations.

Regulatory Developments

While cosyntropin remains FDA-approved for diagnostic use, recent interactions with regulatory authorities suggest interest in broader therapeutic applications. The potential approval pathway for new indications hinges upon demonstrating safety and efficacy through rigorously designed randomized controlled trials (RCTs).

The development landscape also faces challenges related to biosimilar competition, which is increasingly relevant as patent protections for original formulations approach expiry, particularly for products like Cortrosyn (manufactured by AstraZeneca).


Market Analysis

Current Market Landscape

The global cosyntropin market is characterized by its niche status, primarily serving diagnostic laboratories, hospitals, and specialty clinics. As of 2022, the market valuation was estimated at approximately USD 150 million, with North America dominating due to high healthcare expenditure and established endocrine testing workflows [1].

Major pharmaceutical companies, including Sigma-Aldrich (now part of MilliporeSigma) and pharmaceutical giants involved in endocrinology diagnostics, supply cosyntropin preparations. The market's growth correlates with the broader endocrine testing segment, which itself is buoyed by increasing prevalence of adrenal and hormonal disorders.

Market Drivers and Restraints

Key drivers include:

  • Rising prevalence of adrenal disorders: Elevated incidence rates of Addison’s disease and secondary adrenal insufficiency drive demand for diagnostic tools.
  • Advancements in diagnostic technologies: Integration of cosyntropin testing with automated immunoassay platforms enhances clinical utility.
  • Regulatory approvals for new indications: Expanding therapeutic uses could diversify revenue streams.

Restraints involve:

  • Patent expirations: Leading to biosimilar entries that suppress pricing power.
  • Limited therapeutic labeling: The narrow scope of approved indications constrains market expansion.
  • Manufacturing complexities: The peptide's stability challenges increase production costs.

Competitive and Future Market Trends

Emerging biosimilar products could disrupt the market by offering cost advantages, especially in cost-sensitive regions. Furthermore, the trend toward personalized medicine and integration with advanced biomarker diagnostics opens opportunities for innovative applications of cosyntropin derivatives.

Projection models suggest that the global cosyntropin market may grow at a compound annual growth rate (CAGR) of approximately 4% between 2023 and 2030, reaching an estimated USD 200 million by the end of the decade. The growth is expected to be predominantly driven by North America and Europe, but emerging markets in Asia-Pacific, driven by expanding healthcare infrastructure, present significant upside potential.


Future Market Projection and Opportunities

Therapeutic Expansion

The most promising avenue lies in repurposing cosyntropin for autoimmune and inflammatory diseases. Early-stage trials and preclinical data indicate potential benefits in conditions like rheumatoid arthritis and multiple sclerosis, potentially opening monotherapeutic or adjunctive therapy markets.

Regulatory Pathways

Leveraging existing safety and manufacturing data could facilitate accelerated approvals for new indications, particularly under orphan drug or rare disease designations. Engagement with regulatory agencies to define clear development pathways remains critical.

Innovations in Formulation and Delivery

Development of long-acting formulations, transdermal patches, or alternative delivery systems may enhance patient compliance and broaden usage beyond hospital-based diagnostics.


Key Takeaways

  • Clinical Development: Ongoing trials are exploring both diagnostic and therapeutic applications. The outcome of these studies will significantly influence market dynamics.
  • Market Positioning: The cosyntropin market is mature but faces imminent biosimilar competition and potential therapeutic uses.
  • Growth Drivers: Rising adrenal disorder prevalence, diagnostic advancements, and expansion into autoimmune treatments are fueling growth.
  • Challenges: Patent expirations, production costs, and limited indications restrain growth potential, but innovation could mitigate these barriers.
  • Projection Outlook: The market is expected to reach USD 200 million by 2030, with North America and Europe leading, and Asia-Pacific offering new opportunities.

FAQs

1. What are the primary current uses of cosyntropin?
Cosyntropin is predominantly used for diagnostic testing of adrenal insufficiency, including ACTH stimulation tests to evaluate adrenal function.

2. Are there ongoing trials investigating cosyntropin's therapeutic applications?
Yes, early-phase trials are exploring its efficacy in autoimmune conditions such as multiple sclerosis, with preliminary data indicating promising safety profiles.

3. How might biosimilars impact the cosyntropin market?
Biosimilar products could lead to price reductions, increased competition, and broader accessibility but may pressure original manufacturers’ margins.

4. What are key opportunities for market expansion?
Repurposing cosyntropin for autoimmune and inflammatory diseases, developing alternative formulations, and gaining regulatory approvals for new indications represent significant growth prospects.

5. What are the major challenges facing cosyntropin commercialization?
Patent expirations, manufacturing complexities, limited therapeutic indications, and regional regulatory hurdles are primary obstacles.


References

[1] Market Research Future, "Cosyntropin Market Analysis 2022," MarketWatch, 2022.

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