痛经女性福音！艾拉戈克钠缓解痛经疗效高达75.8%！价格呢？

Current data shows that as many as 176 million women worldwide suffer from endometriosis. How effective is Elagog sodium as a drug for the treatment of moderate to severe endometriosis? What about price? In this article, the editor will take you to understand who Elagokna is~

endometriosis

Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by extrauterine implantation of endometrioid tissue that affects 6% to 10% of women of childbearing age. Endometriosis symptoms include dysmenorrhea, non-menstrual pelvic pain, and less common symptoms such as pain during ovulation, constipation, and painful urination. Endometriosis-related pain reduces patients' quality of life and imposes a significant economic burden. So what exactly causes endometriosis?

Endometriosis has multiple causes, including retrograde menstruation, genetic and environmental factors, immune system alterations, and ectopic differentiation of mesenchymal stem cells. Estrogen has proliferative and anti-apoptotic effects in endometrial cells and stimulates local and systemic inflammation. According to the "estrogen threshold hypothesis," complete suppression of estrogen may not be necessary to control endometriosis-related pain, and estrogen may be adjusted to levels sufficient to control pain but minimize estrogen effects.

Who is Elagokna?

Elagolix is the first drug for the treatment of moderate to severe endometriosis and was approved for marketing in the United States in 2018.

What are the countermeasures of Elagog sodium for endometriosis? Elagog sodium is a gonadotropin-releasing hormone (GnRH) receptor antagonist that inhibits its signal transmission by competitively binding to the gonadotropin-releasing hormone receptor in the pituitary gland, resulting in dose-dependent inhibition of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), reducing the blood concentrations of ovarian sex hormones, estradiol and progesterone, thus achieving the effect of treating endometriosis.

How effective is Elagog Sodium?

In July 2017, "N Engl J Med" published a double-blind, randomized 6-month phase III trial to evaluate the effect of two doses of Elagog sodium, 150 mg once daily (low-dose group) and 200 mg twice daily (high-dose group), compared with placebo in women with surgical diagnosis of endometriosis. Its primary efficacy endpoint was the proportion of women with dysmenorrhea and nonmenstrual pelvic pain who had a clinical response.

A total of 872 women were randomly assigned in a 2:2:3 ratio to receive the low-dose group, the high-dose group, or the placebo group. Of these women, 653 (74.9%) completed treatment. Its experimental research results show:

At 3 months, among women who had a clinical response to dysmenorrhea, 46.4% in the low-dose group were 26.8% higher than placebo, and 75.8% were higher than 56.2% higher than placebo in the high-dose group. Among women who had a clinical response to nonmenstrual pelvic pain, 50.4% were in the low-dose group, 13.9% higher than placebo, and 54.5% in the high-dose group, 18% higher than placebo. The clinical response to dysmenorrhea and non-menstrual pelvic pain lasted until 6 months. The specific data are shown in Figure 1.

Figure 1: Proportion of women with clinical responses to dysmenorrhea and non-menstrual pelvic pain in the high-dose, low-dose and placebo groups

As can be seen, the proportion of women who met the criteria for the primary efficacy endpoint at each dose was significantly higher than the proportion of women who received placebo.

In summary, in women with endometriosis-related pain, the efficacy of low-dose and high-dose Elagog sodium in improving dysmenorrhea and non-menstrual pelvic pain within 6 months is very impressive!

What is the price of Elagog sodium? Where to buy?

Elagog sodium is very effective, so what is its price? The latest price of Elagog Sodium Tablets in 2023 is $13,340 per box.

So where can you buy it? Medical Companion Travel specializes in medical treatment abroad, providing targeted drugs, generic drugs, and anti-cancer drugs, etc., providing patients with one-stop overseas medical services. Patients can turn to Medical Companion Travel to purchase Elagog sodium for you safely and conveniently. On the one hand, you do not need to travel back and forth overseas. On the other hand, Elagog sodium purchased through Medical Companion Travel is more economical and affordable. It is currently the most helpful drug purchasing channel for patients. If you want to know other information, please consult Medical Companion Travel for details.

Global R&D of Endometriosis Drugs

Currently, there are 122 drugs for endometriosis, in addition to Alagog sodium, which is already on the market. 5 drugs are currently in the preclinical stage, 2 drugs are in the drug discovery stage, 1 drug is in an unknown clinical stage, 2 drugs are in the early clinical phase 1 stage, and there are 2 drugs in the clinical phase 1 stage. There are 3 kinds of drugs in clinical stage, 22 kinds in clinical phase 2, 1 kind in clinical phase 2/3, there are currently 3 kinds in clinical phase 3, and 2 kinds are applied for marketing. I believe they will meet us in the near future. In addition, there are 32 kinds of drugs that have appeared in front of you. Today I will briefly introduce two kinds for you:

Relugoli tablets

In January 2019, Relugolix was approved by the Japanese Food and Drug Administration to relieve symptoms such as menorrhagia and lower abdominal pain related to uterine fibroids. This is the first time that the Japanese Food and Drug Administration has approved a GnRH receptor antagonist drug for the treatment of uterine fibroids.

Rilugolix is an oral gonadotropin-releasing hormone receptor antagonist that can treat endometriosis by competitively binding to the pituitary GnRH receptor to reduce the release of luteinizing hormone and follicle-stimulating hormone.

triptorelin pamoate

Triptorelin is a synthetic decapeptide analogue of gonadotropin-releasing hormone (GnRH). It can powerfully inhibit the secretion of gonadotropin and its activity is stronger than natural GnRH. Triptorelin treats endometriosis and uterine fibroids in women. After the start of administration, there will be a transient peak in the levels of luteinizing hormone, follicle-stimulating hormone, and estradiol in the blood circulation. After continuous long-term administration, a continuous decrease in the secretion of luteinizing hormone and follicle-stimulating hormone and a significant reduction in ovarian steroid synthesis can generally be observed 2 to 4 weeks after the start of treatment.

Dr. Liao Xi, director of the Reproductive Center of Beijing Jiayuan Hospital, once said: "Depending on the severity of endometriosis, it may only require simple drug treatment, or laparoscopic surgery may be performed to remove endometriosis lesions. Studies have shown that patients whose endometriosis makes it difficult to get pregnant can significantly increase their pregnancy rate after surgery (that is, using assisted reproductive technology). Pregnancy itself is also a favorable state for endometriosis, which can be said to kill two birds with one stone!"

References

[1]Taylor HS, Giudice LC, Lessey BA, Abrao MS, Kotarski J, Archer DF, Diamond MP, Surrey E, Johnson NP, Watts NB, Gallagher JC, Simon JA, Carr BR, Dmowski WP, Leyland N, Rowan JP, Duan WR, Ng J, Schwefel B, Thomas JW, Jain RI, Chwalisz K. Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist. N Engl J Med. 2017 Jul 6;377(1):28-40. doi: 10.1056/NEJMoa1700089. Epub 2017 May 19. PMID: 28525302.

[2]Sun-Wei Guo. (2023) Various types of adenomyosis and endometriosis: in search of optimal management. Fertility and Sterility 119:5, 711-726.

[3]Serdar E. Bulun, Sule Yildiz, Mazhar Adli, Debabrata Chakravarti, James Brandon Parker, Magdy Milad, Linda Yang, Angela Chaudhari, Susan Tsai, Jian Jun Wei, Ping Yin. (2023) Endometriosis and adenomyosis: shared pathophysiology. Fertility and Sterility 119:5, 746-750.