Clinical studies have demonstrated the efficacy of osilodrostat in rapidly reducing urinary free cortisol levels, leading to its regulatory approval.[28] Ongoing research focuses on refining dosage strategies (e.g., initial dosing of 10 mg twice daily), managing drug interactions (osiolodrostat inhibits cytochrome P450 3A4, cytochrome P450 1A2, cytochrome P450 2C19), and characterizing adverse events such as adrenal insufficiency, hypokalemia, hypertension, and androgen excess.[29–31]. This evidence concerns the gene CYP2C19 and Adrenal insufficiency.