What are the functions and efficacy of elagolix?

Elagolix is an oral gonadotropin-releasing hormone antagonist (GnRHA) that has good efficacy in treating menstrual pain and non-menstrual pelvic pain caused by endometriosis. Compared with the well-known GnRH agonist (GnRHa) in the past, it has higher oral bioavailability, avoids pain and allergic reactions caused by injection, and increases patient compliance.

Indications

Elagolix is an oral short-acting gonadotropin-releasing hormone receptor (GnRH) antagonist jointly developed by AbbVie and Neurovrine Biosciences. It exerts its efficacy by competing with the GnRH receptor in the pituitary gland and reducing the level of gonadotropins in the blood circulation. On July 23, 2018, elagolix was approved for the treatment of endometriosis, becoming the first new drug approved by the U.S. Food and Drug Administration for the treatment of endometriosis.

Elagolix sodium (elagolix) functions and efficacy

Endometriosis occurs in 10% of women of childbearing age and is a common source of chronic pelvic pain, infertility, and comorbid conditions. It usually presents with some combination of dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Treatment options may be surgery or hormones. Traditional treatments are divided into medical and surgical. The latter, although effective, is only used in surgical emergencies and in patients where medical management has failed. Pharmacological treatment with NSAIDs often has limited efficacy. It is usually based on hormonal suppression leading to atrophy of endometrial lesions.

Elagolix is a GnRH antagonist that inhibits the entire pituitary-gonadal axis. Reduction in estrogen and progesterone levels leads to regression of endometrial lesions and improvement of symptoms. Elagolix can cause a dose-dependent suppression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as decreased blood concentrations of the ovarian sex hormones, estradiol, and progesterone. These effects can reduce a woman's menstrual flow, relieve pain, and help control the growth of uterine fibroids.

Clinical trials have shown that elagolix can effectively treat dysmenorrhea and non-menstrual pain secondary to endometriosis, and it is well tolerated and relatively safe to use. Studies lasting up to 12 months show that, over time, menstrual cramps are reduced by up to 75% and non-menstrual pain is reduced by 50%-60%. Elagolix was found to be effective compared to placebo and alternative treatments.

Elagolix

Pregnancy should be ruled out before starting elagolix or elagolix should be started within 7 days of the start of menstruation. Elagog sodium can be taken with or without food, but Elagog sodium should be taken at approximately the same time each day.

Start treatment with elagolix 150 mg once daily. The maximum treatment duration is 24 months. If the patient has dyspareunia, consider starting treatment with elagolix 200 mg twice daily for a maximum of 6 months.

Patients with moderate hepatic impairment are initiated with elagolix 150 mg once daily, and 200 mg twice daily is not recommended.

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