Cetrorelix
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
- Cetrorelix
- Cetrorelix: From Inhibition of Premature LH Surges in Fertility Treatment to Hypertrichosis
Cetrorelix: From Inhibition of Premature LH Surges in Fertility Treatment to Hypertrichosis
One-Sentence Summary
Cetrorelix is a GnRH receptor antagonist used to prevent premature LH surges in women undergoing controlled ovarian stimulation as part of fertility treatment. The TxGNN model predicts it may be effective for hypertrichosis, but no clinical trials and no publications currently support this direction. The prediction rests on the model score alone (evidence level L5).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Inhibition of premature LH surges in women undergoing controlled ovarian stimulation (from pharmacology data; the approved indication text on the Singapore licence is blank) |
| Predicted New Indication | Hypertrichosis |
| TxGNN Prediction Score | 99.98% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 1 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Cetrorelix is a peptide antagonist of the GnRH1 receptor (gene GNRHR). By blocking this receptor it suppresses LH and FSH release and, downstream, gonadal sex-steroid production. Detailed mechanism of action data is not otherwise available.
In theory, lowering androgen signalling could affect androgen-dependent hair growth. However, most forms of hypertrichosis (congenital, drug-induced, syndromic) are not mainly driven by gonadal androgens, so the link is speculative. The high TxGNN score is not backed by any trial or publication.
The other top predictions are also weakly supported:
- Ambras type hypertrichosis universalis congenita, malformation syndromes, Dandy-Walker–related syndrome, isolated hair shaft abnormality, familial trichomegaly, persistent fetal circulation syndrome: these are genetic or developmental conditions with no plausible GnRH-pathway mechanism. They are likely graph-based artefacts.
- Aromatase excess syndrome: the primary defect is peripheral aromatisation, so aromatase inhibitors are the logical therapy.
- Familial male-limited precocious puberty: this is the most biologically coherent hypothesis, flagged as a research question. The defect (activating LHCGR mutation) lies downstream of GnRH, so monotherapy is not expected to work. No direct evidence exists.
- Central precocious puberty: this is mechanistically well aligned, but cetrorelix is short-acting and not formulated for chronic depot use, and GnRH agonists already serve this indication. It is also flagged as a research question.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN11345P | CETROTIDE INJECTION 0.25 mg | Injection | Not stated in the licence data |
Safety Considerations
- Drug Interactions: No drug–drug interactions were identified. The only pharmacology entry is the drug's own target, the GnRH1 receptor, which is not an interaction.
- Other considerations: Use in neonates (relevant to persistent fetal circulation syndrome) would raise additional safety concerns.
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction for hypertrichosis is supported only by a model score. There are no trials or publications, and the mechanistic link is speculative. Safety data from the package insert has not yet been obtained.
To proceed, the following is needed:
- The package insert warnings and contraindications from HSA
- Detailed mechanism of action data from DrugBank
- A literature and trial search for cetrorelix in hypertrichosis
- If pursued, a focused review of central precocious puberty and familial male-limited precocious puberty, the two most mechanistically coherent candidates, considering the short-acting formulation and existing standard therapies
- Assessment of route and formulation compatibility (currently only an injection is available)
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.