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

Inclusion Criteria

• Male or female participants must be aged 16 years or older at the time of signing the informed consent/assent.
• In participants aged 2 times the upper limit of normal (ULN) or elevated liver function tests (alanine aminotransferase [ALT] or aspartate aminotransferase [AST] >2 times the ULN).
• History of bilateral adrenalectomy.
• History of malignancy (other than basal cell carcinoma successfully treated >26 weeks prior to entry into the study).
• Participants who have type 1 diabetes or receive regular insulin, have uncontrolled diabetes, or have a screening HbA1c greater than 8%.
• Persistent signs of adrenal insufficiency or the participant does not tolerate treatment at the end of the 4-week run-in period.
• Participants with any other significant medical or psychiatric conditions that in the opinion of the Investigator would preclude participation in the study.
• Participants on regular daily inhaled, topical, nasal or oral steroids for any indication other than CAH.
• Co-morbid condition requiring daily administration of a medication or consumption of any material that interferes with the metabolism of glucocorticoids.
• Participants who are receiving <10 mg hydrocortisone dose at screening or the hydrocortisone dose equivalent.
• Participants anticipating regular prophylactic use of additional steroids e.g. for strenuous exercise.
• Participation in another clinical study of an investigational or licensed drug or device within the 12 weeks prior to screening.
• Inclusion in any natural history or translational research study that would require evaluation of androgen levels during the study period outside of this protocol's assessments.
• Participants who have previously been exposed to Chronocort in any Diurnal study.
• Participants who routinely work night shifts and so do not sleep during the usual night-time hours.
• Participants, who in the opinion of the Investigator, will be unable to comply with the requirements of the protocol.
• Participants with a known hypersensitivity to any of the components of the Chronocort capsules, the Cortef tablets, or the placebo capsules.
• Participants with congenital galactosemia, malabsorption of glucose and galactose, or who are lactase deficient.
• Participants with a body weight of 45 kg or less.