SUPPRESSION OF FOLLICULAR PHASE PITUITARY-GONADAL FUNCTION BY A POTENT NEW GONADOTROPIN-RELEASING-HORMONE ANTAGONIST WITH REDUCED HISTAMINE-RELEASING PROPERTIES (GANIRELIX)
Lr. Nelson et al., SUPPRESSION OF FOLLICULAR PHASE PITUITARY-GONADAL FUNCTION BY A POTENT NEW GONADOTROPIN-RELEASING-HORMONE ANTAGONIST WITH REDUCED HISTAMINE-RELEASING PROPERTIES (GANIRELIX), Fertility and sterility, 63(5), 1995, pp. 963-969
Objective: To determine if daily subcutaneous doses of ganirelix will
suppress and maintain E(2) less than or equal to 30 pg/mL (conversion
factor to SI unit, 3.671), the serum profiles of LH and FSH during and
after cessation of treatment, the time-course of the resumption of no
rmal ovarian function after ganirelix cessation, and to identify side
effects of daily treatment. Design: Open-label nonrandomized clinical
study. Setting: Normal human volunteers in an academic research center
. Patients: Women 21 to 45 years of age, with documented ovulatory men
strual cycles. Interventions: Ganirelix was administered subcutaneousl
y daily for 8 days. Blood samples were obtained during dosing as well
as before and after cessation of dosing. Main Outcome Measures: Change
s in serum E(2), LH, FSH, P, and ganirelix. Results: Ganirelix treatme
nt rapidly decreased serum levels of gonadotropins and E(2) after both
1 and 2 mg administration. Twenty-four hours after the first dose of
ganirelix, E(2) decreased from a mean +/- SEM of 50 +/- 8 and 67 +/- 1
1 pg/mL at baseline to 25 +/- 4 and 20 +/- 3 in the 1 mg and 2 mg grou
ps, respectively. Estradiol remained suppressed (mean levels < 26 pg/m
L) on all subsequent 7 days of ganirelix dosing in both groups. After
the final dose of ganirelix, there was a rapid return of ovarian funct
ion in all volunteers. All women had P levels indicative of ovulation
in the subsequent cycle, and the mean number of days from the final ga
nirelix dose to the next menses was 25.8 +/- 2.1 and 27.3 +/- 1.6 in t
he 1 and 2 mg groups, respectively. Conclusions: Daily ganirelix admin
istration is effective in suppressing the pituitary-gonadal axis and h
as a side effect profile that should be well tolerated.