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Congenital Adrenal Hyperplasia

Nephrology
16
Pipeline Programs
9
Companies
25
Clinical Trials
5 recruiting
1
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
4
2
2
0
7
1
Early DiscoveryClinical DevelopmentMarket

Nephrology is a $36.6B mature market dominated by cardiometabolic crossover drugs with limited pure renal innovation.

$36.6B marketMature→ Stable30 products15 companies

Key Trends

  • GLP-1 agonists and SGLT2 inhibitors dominate (69% of spending) due to dual cardio-renal benefits
  • Patent cliffs approaching 2026-2030 create generic conversion risk for blockbuster franchises
  • Pipeline activity remains robust (2,785 trials) but concentrated in early-phase basic research

Career Verdict

Nephrology offers stable employment in commercial and medical affairs roles, but limited growth upside due to mature blockbuster dependency and declining pure renal research focus.

AI-generated market analysis based on FDA, CMS, ClinicalTrials.gov, and hiring data

Market Leaders

#1OZEMPICStable
$9.2B
Novo Nordisk·Peak12.4yr
#2JARDIANCEStable
$8.8B
#4FARXIGAStable
$4.3B
AstraZeneca·Peak15.4yr

Drug Class Breakdown

Glucagon-like Peptide-1 (GLP-1) Agonists
$16.6B(45%)

cardiometabolic dominance

Sodium-Glucose Transporter 2 Inhibitors
$8.8B(24%)

cardioprotective expansion

SGLT2 Inhibitors (dapagliflozin class)
$4.3B(12%)

heart failure crossover

Adrenergic Beta3-Agonists
$3.0B(8%)

overactive bladder niche

Dipeptidyl Peptidase 4 Inhibitors
$1.3B(4%)

declining relevance

Career Outlook

Stable

Nephrology careers are stable but not expanding; the field is supported by blockbuster drugs (GLP-1s, SGLT2i) that face patent cliffs between 2026–2041, creating near-term employment security but long-term uncertainty. Commercial and medical affairs roles dominate hiring, while R&D investment is limited to niche mechanisms (complement inhibition, gene therapy). Career progression depends on specialization in medtech, diagnostics, or orphan nephrology rather than traditional pharma blockbuster development.

Breaking In

Target medtech platforms (Outset, Fresenius) or biotech innovators (Vertex, Calyxo) over traditional pharma; nephrology offers job stability and clinical depth but limited growth trajectory in pure pharmaceutical roles.

For Experienced Professionals

Leverage cardiometabolic expertise to span diabetes, CKD, and HF franchises; position for transition to orphan nephrology (ADPKD, FSGS, IgA) where innovation and valuation multiples are highest.

In-Demand Skills

Renal endpoints and biomarkers (eGFR, albuminuria)Cardio-renal crossover knowledge (diabetes + CKD + HF)Medtech systems expertise (dialysis, transplantation platforms)Medical affairs and key opinion leader management

Best For

Medical Science Liaison (renal specialists)Commercial Manager (established nephro franchise)Clinical Development Manager (rare kidney disease)Real-world evidence analyst (CKD outcomes)

Hiring Landscape

$108K–$330K

Nephrology hiring is concentrated in commercial roles (58 positions, $108K avg) and medical affairs (12 positions, $330K avg), reflecting mature market dynamics. Top hiring companies are innovative platforms (Vertex: 41 jobs) and medtech (Outset: 21 jobs), not traditional pharma. Salary compression in commercial roles suggests commoditization.

124
Open Roles
5
Companies Hiring
4
Departments

Top Hiring Companies

20Growing
8Stable

By Department

Commercial(47%)
$108K
Medical Affairs(10%)
$330K
Clinical Excellence(6%)
$140K
Quality Assurance(4%)
$201K

Hiring favors medtech and biotech platforms over traditional pharma; medical affairs offers premium compensation but limited volume; commercial roles are abundant but underpaid relative to other therapeutic areas.

On Market (1)

Approved therapies currently available

Neurocrine Biosciences
CRENESSITYApproved
crinecerfont
Neurocrine Biosciences
Corticotropin-releasing Factor Type 1 Receptor Antagonist [EPC]oral2024

Competitive Landscape

9 companies ranked by most advanced pipeline stage

Neurocrine Biosciences
11 programs
2
1
1
7
1
ChronocortPhase 31 trial
ChronocortPhase 31 trial
Chronocort®Phase 31 trial
Chronocort®Phase 31 trial
CrinecerfontPhase 32 trials
+6 more programs
Active Trials
NCT03019614Completed30Est. Apr 2010
NCT02349503Withdrawn0Est. Oct 2015
NCT00519818Completed20Est. May 2009
+9 more trials
Angeles Therapeutics
Angeles TherapeuticsCA - Los Angeles
2 programs
1
1
Abiraterone acetatePhase 21 trial
Abiraterone acetatePhase 11 trial
Active Trials
NCT02574910Terminated4Est. Jun 2023
NCT03548246Withdrawn0Est. Jan 2026
Lundbeck
LundbeckDenmark - Copenhagen
1 program
1
Lu AG13909Phase 1/21 trial
Active Trials
NCT05669950Recruiting42Est. Dec 2027
Human BioSciences
Human BioSciencesWV - Martinsburg
1 program
1
Abiraterone acetatePhase 1
Spruce Biosciences
Spruce BiosciencesSOUTH SAN FRANCISCO, CA
5 programs
SPR001PHASE_21 trial
SPR001PHASE_21 trial
TildacerfontPHASE_21 trial
Tildacerfont/PlaceboPHASE_21 trial
Tildacerfont/PlaceboPHASE_21 trial
Active Trials
NCT03687242Completed11Est. Aug 2019
NCT03257462Completed24Est. Mar 2019
NCT05128942Terminated67Est. Jan 2025
+2 more trials
Crinetics Pharmaceuticals
4 programs
atumelnantPHASE_21 trial
atumelnantPHASE_21 trial
AtumelnantPHASE_2_31 trial
AtumelnantPHASE_31 trial
Active Trials
NCT05907291Completed38Est. Aug 2025
NCT06712823Recruiting150Est. Nov 2027
NCT07159841Recruiting153Est. Mar 2030
+1 more trials
Sanofi
SanofiPARIS, France
1 program
Baby Detect : Genomic Newborn ScreeningN/A
Takeda
TakedaTOKYO, Japan
1 program
Baby Detect : Genomic Newborn ScreeningN/A1 trial
Active Trials
NCT05687474Completed6,824Est. Jun 2025
Orchard Therapeutics
1 program
Baby Detect : Genomic Newborn ScreeningN/A

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Crinetics PharmaceuticalsAtumelnant
Neurocrine BiosciencesChronocort
Neurocrine BiosciencesChronocort
Neurocrine BiosciencesCrinecerfont
Neurocrine BiosciencesCrinecerfont
Neurocrine BiosciencesChronocort®
Neurocrine BiosciencesHydrocortisone
Neurocrine BiosciencesChronocort®
Crinetics PharmaceuticalsAtumelnant
Neurocrine BiosciencesCrinecerfont
Neurocrine BiosciencesCrinecerfont
Crinetics Pharmaceuticalsatumelnant
Crinetics Pharmaceuticalsatumelnant
Angeles TherapeuticsAbiraterone acetate
Spruce BiosciencesTildacerfont

Showing 15 of 25 trials with date data

Clinical Trials (25)

Total enrollment: 8,364 patients across 25 trials

A Study to Evaluate Atumelnant in Adults With Congenital Adrenal Hyperplasia

Start: Dec 2025Est. completion: May 2027150 patients
Phase 3Recruiting

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

Start: May 2022Est. completion: Feb 202455 patients
Phase 3Completed

Long-term Safety Study of Chronocort in the Treatment of Participants With Congenital Adrenal Hyperplasia

Start: Apr 2022Est. completion: Jan 202676 patients
Phase 3Completed

Global Safety and Efficacy Registration Study of Crinecerfont in Pediatric Participants With Classic Congenital Adrenal Hyperplasia (CAHtalyst Pediatric Study)

Start: Jun 2021Est. completion: Aug 2027103 patients
Phase 3Active Not Recruiting

Global Safety and Efficacy Registration Study of Crinecerfont for Congenital Adrenal Hyperplasia

Start: Dec 2020Est. completion: Aug 2027182 patients
Phase 3Active Not Recruiting

Open-label Comparison of Chronocort® Versus Standard Glucocorticoid Replacement Therapy

Start: Oct 2018Est. completion: Jul 20210
Phase 3Withdrawn

A Study of the Efficacy, Safety and Tolerability of Chronocort in Treating CAH

Start: Aug 2016Est. completion: Jul 202291 patients
Phase 3Completed

Comparison of Chronocort® With Standard Glucocorticoid Therapy in Patients With Congenital Adrenal Hyperplasia

Start: Feb 2016Est. completion: Jul 2018122 patients
Phase 3Completed

A Study in Pediatric Participants With Congenital Adrenal Hyperplasia (Balance-CAH)

Start: Jan 2026Est. completion: Mar 2030153 patients
Phase 2/3Recruiting

Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Crinecerfont in Participants With Classic Congenital Adrenal Hyperplasia (CAH) Who Are Less Than 4 Years Old

Start: Apr 2026Est. completion: Mar 202820 patients
Phase 2Not Yet Recruiting

Pharmacokinetics, Safety and Tolerability of Crinecerfont in Participants With Congenital Adrenal Hyperplasia Who Are Less Than 2 Years Old

Start: Sep 2025Est. completion: Oct 20296 patients
Phase 2Recruiting

An Extension Study to Evaluate Safety and Efficacy in Participants Treated With CRN04894

Start: Feb 2025Est. completion: Nov 2027150 patients
Phase 2Recruiting

Evaluate the Safety, Efficacy, and Pharmacokinetics of CRN04894 in Participants With Congenital Adrenal Hyperplasia (TouCAHn)

Start: Jul 2023Est. completion: Aug 202538 patients
Phase 2Completed

Androgen Reduction in Congenital Adrenal Hyperplasia

Start: Jan 2023Est. completion: Jan 20260
Phase 2Withdrawn

A Phase 2 Study to Evaluate the Safety, Efficacy and PK of Tildacerfont in Children Aged 2-17 Years With CAH

Start: Dec 2021Est. completion: Jan 202567 patients
Phase 2Terminated
NCT04544410Spruce BiosciencesTildacerfont/Placebo

A Ph2b to Evaluate Tildacerfont in the Reduction of Glucocorticoid Steroid Doses in Adult CAH

Start: Feb 2021Est. completion: Jan 2025100 patients
Phase 2Terminated
NCT04457336Spruce BiosciencesTildacerfont/Placebo

A Ph2b to Evaluate Clinical Efficacy and Safety of Tildacerfont in Adult CAH

Start: Aug 2020Est. completion: May 202496 patients
Phase 2Terminated

Study to Evaluate the Safety and Efficacy of SPR001 in Subjects With Classic Congenital Adrenal Hyperplasia

Start: Sep 2018Est. completion: Aug 201911 patients
Phase 2Completed

Study of SPR001 in Adults With Classic Congenital Adrenal Hyperplasia

Start: Jul 2017Est. completion: Mar 201924 patients
Phase 2Completed

A Trial of Lu AG13909 in Participants With Congenital Adrenal Hyperplasia

Start: Dec 2022Est. completion: Dec 202742 patients
Phase 1/2Recruiting

Comparison of Two Forms of Hydrocortisone in Patients With Congenital Adrenal Hyperplasia

Start: Aug 2007Est. completion: May 200920 patients
Phase 1/2Completed

Androgen Reduction in Congenital Adrenal Hyperplasia, Phase 1

Start: Aug 2017Est. completion: Jun 20234 patients
Phase 1Terminated

Safety, Pharmacokinetics and Pharmacodynamics of NBI-77860 in Adolescent Females With Congenital Adrenal Hyperplasia

Start: Feb 2015Est. completion: Oct 20150
Phase 1Withdrawn

An Open Label Study in Healthy Volunteers to Compare Chronocort® to Hydrocortisone

Start: Mar 2010Est. completion: Apr 201030 patients
Phase 1Completed
NCT05687474TakedaBaby Detect : Genomic Newborn Screening

Baby Detect : Genomic Newborn Screening

Start: Sep 2022Est. completion: Jun 20256,824 patients
N/ACompleted

Related Jobs in Nephrology

Phase Legend

PreclinicalLab & animal studies
Phase 1Safety & dosing
Phase 2Efficacy testing
Phase 3Large-scale trials
On MarketApproved & available

Key Insights

7 late-stage (Phase 3) programs, potential near-term approvals
5 actively recruiting trials targeting 8,364 patients
9 companies competing in this space

The information on this page is for informational purposes only and should not be used as a substitute for professional medical advice. Drug information is sourced from FDA, DailyMed, and other government databases. Adverse event data from FAERS does not establish causation. Always consult a healthcare professional for medical decisions.