Although cortisol replacement (hydrocortisone, prednisone, or dexamethasone, for example) and Florinef have virtually eliminated mortality, there are at least two reasons for continuing to try to perfect our treatment regimens: (1) the linear growth of children is suboptimal and the end result is an adult who is too short, and (2) over-treatment with glucocorticoids in children may increase risk of osteoporosis in later years.

Based on studies of the regulation of release of ACTH (that, in turn, drives the production of hormones from the adrenal cortex), we have found that we can decrease the amount of ACTH using calcium channel blockers (medications typically used to treat high blood pressure, such as amlodipine). Amlodipine has been shown to be safe even in infants treated for a variety of medical reasons.

Our hypothesis is that addition of amlodipine will allow us to decrease the amount of glucocorticoid medication that your child is currently taking to control his/her CAH. Such a decrease should translate into better growth and bone strength. This new medication would be added to your child’s current CAH treatment program and evaluated in a double-blind/placebo-controlled crossover study.