Chemistry Alum’s Company Wins FDA Approval for First Oral Acromegaly Drug
As co-founder and chief scientific officer of Crinetics Pharmaceuticals, Stephen Betz, who holds a Ph.D. in chemistry from the University of North Carolina, is celebrating one of the most meaningful moments of his career—the U.S. Food and Drug Administration approval of Palsonify, or paltusotine, the first once-daily, oral treatment for adults with acromegaly.
November 5, 2025 I By Dave DeFusco
When Stephen Betz arrived at the University of North Carolina to study chemistry, he didn’t know his work would someday help transform the lives of people living with a rare, often misunderstood disease called acromegaly. Three decades later, as co-founder and chief scientific officer of Crinetics Pharmaceuticals, Betz is celebrating one of the most meaningful moments of his career—the U.S. Food and Drug Administration approval of Palsonify, or paltusotine, the first once-daily, oral treatment for adults with acromegaly.
“It’s the culmination of everything we’ve worked for,” said Betz. “To take an idea from scratch, turn it into a medicine and see it make a difference in people’s lives. It’s an incredible privilege.”
Acromegaly is caused by a small, usually noncancerous tumor on the pituitary gland, a tiny organ at the base of the brain that controls hormone production. The tumor causes the gland to release too much growth hormone, which in turn raises the level of another hormone called IGF-1, or insulin-like growth factor 1.
“When IGF-1 and growth hormone are overproduced, the body keeps growing in ways it shouldn’t,” said Betz. “Hands, feet and facial bones enlarge, but the real danger is to vital internal organs, like the heart, which also grow, leading to serious health problems, even early death if untreated.”
Until now, people with acromegaly have had to rely on painful, monthly depot injections to control their symptoms. These injections are peptides that mimic the action of the hormone somatostatin, which naturally works to shut down the release of growth hormone in the pituitary gland. But the shots have to be given with thick needles every month and don’t always provide consistent symptom control.
“Imagine having to plan your life around a painful injection every four weeks,” said Betz. “If you travel, if the injection’s late or if it’s given incorrectly, your symptoms—headache, excessive sweating, joint pain, sleep disturbances—can come roaring back. That’s the reality for many patients.”
That’s why Crinetics set out to design a small-molecule drug that could activate the same “off switch” in the pituitary gland, but in pill form.
“Somatostatin has five different receptors in the body,” said Betz. “One of them, called somatostatin receptor type 2, or SST2, is responsible for controlling growth hormone secretion. If we can turn that one on and leave the others alone, we can treat acromegaly without unwanted side effects.”
That idea became paltusotine, the active ingredient in Palsonify. Unlike older therapies made from peptides that must be injected, paltusotine is designed to be absorbed through the stomach and taken once a day.
“The beauty of medicinal chemistry,” said Betz, “is that every atom in the drug can be adjusted for potency, selectivity, absorption and safety. You poke and prod each piece until it does exactly what you want.”
Betz’s ability to think that way—methodically, creatively and persistently—took root at UNC-Chapel Hill, where he earned his Ph.D. in chemistry under Gary Pielak, the Kenan Distinguished Professor of Chemistry, Biochemistry and Biophysics.
“My experience at UNC is where I really learned how to be a scientist,” said Betz. “Gary didn’t hand us a list of experiments. He taught us to think, to ask our own questions, to work collaboratively and to let data, not assumptions, guide our conclusions.”
After earning his doctorate, Betz worked in industry before co-founding Crinetics Pharmaceuticals with fellow scientist Scott Struthers, who now serves as the company’s CEO. They started small—just four scientists and two dogs in a modest San Diego lab with about six months of funding—but with a shared bold vision: to use chemistry to make powerful therapies easier to take, safer and more effective.
“From the start, our goal was to not only replace injections with pills but to provide better, more stable coverage for people with acromegaly,” said Betz. “It sounds simple but in endocrinology, it’s anything but.”
With its first FDA-approval in September, Crinetics has entered a new chapter, moving from a research and development company to a fully commercial one. But Betz sees the milestone as a beginning, not an end.
“We’re just getting started,” he said. “Paltusotine is now in a phase-three trial for another condition called carcinoid syndrome, and we have several other first-in-class drugs in development for rare endocrine diseases. The future is bright.”
To help patients navigate access and insurance, Crinetics also launched CrinetiCARE, a support program offering education, financial help and guidance to anyone prescribed Palsonify, which hit the U.S. market this month.
“The healthcare system is complicated enough,” said Betz. “We didn’t want access to be another barrier for patients or their physicians.”
For Betz, seeing the company’s first molecule become an approved medicine is deeply personal—the reward for years of persistence, problem-solving and partnership.
“When we started this company, it was just an idea, a sketch on paper,” he said. “Now, there are real people taking a drug we designed, and it’s changing their lives. That’s a pretty amazing thing to be able to do for a living.”