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Nasacthin is an investigational intranasal diagnostic formulation of tetracosactide, a synthetic 24-amino acid analogue of adrenocorticotropic hormone (ACTH). Developed by the Sheffield Children's NHS Foundation Trust, it is designed for the needle-free diagnosis of adrenal insufficiency. The formulation combines tetracosactide with chitosan, a mucoadhesive agent that enhances nasal absorption. Upon administration, tetracosactide stimulates the melanocortin 2 receptors in the adrenal cortex to produce cortisol. Unlike the standard intravenous Synacthen test, Nasacthin allows for a non-invasive assessment by measuring glucocorticoid levels (cortisol and cortisone) in saliva samples. It is currently being evaluated in the STARLIT clinical program (including STARLIT-2 and STARLIT-3 trials) as a potential replacement for the traditional short Synacthen test.
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