title: Overview of elagolix for the treatment of endometriosis.
abstract: BACKGROUND
  Suppression of sex-steroid secretion is required in a variety of gynecological conditions. This can be achieved using gonadotropin releasing hormone (GnRH) agonists that bind pituitary gonadotropin receptors and antagonize the link-receptor of endogenous GnRH, inhibiting the mechanism of GnRH pulsatility. On the other hand, GnRH antagonists immediately reduce gonadal steroid levels, avoiding the initial stimulatory phase of the agonists. Potential benefits of GnRH antagonists over GnRH agonists include a rapid onset and reversibility of action. Older GnRH antagonists are synthetic peptides, obtained by modifications of certain amino acids in the native GnRH sequence. They require subcutaneous injections, implantation of long-acting depots. The peptide structure is responsible for histamine-related adverse events and the tendency to elicit hypersensitivity reactions.
  
  
  METHODS
  Research has worked towards the development of non-peptidic molecules exerting antagonist action on GnRH. They are available for oral administration and may have a more beneficial safety profile in comparison with peptide GnRH antagonists. This article focuses on the data of the literature about elagolix, a novel non-peptidic GnRHantagonist, in the treatment of endometriosis.
  
  
  CONCLUSIONS
  Elagolix demonstrated efficacy in the management of endometriosis-associated pain and had an acceptable safety and tolerability profile. However, further studies are necessary to evaluate its non-inferiority in comparison with other endometriosis's treatments.
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Neri
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Corda
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Malune
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Piras
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pirarba
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guerriero
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Orrù
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Maurizio Nicola
authors.initials: MN
authors.lastname: D'Alterio
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Angioni
authors.affiliation: a Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche , Università di Cagliari , Cagliari , Italy.|b Clinica Ostetrica e Ginecologica , Azienda Ospedaliero Universitaria di Cagliari, Policlinico Duilio Casula , Monserrato , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paoletti
mesh_terms: D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D011743:Pyrimidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D006727:Hormone Antagonists; D006845:Hydrocarbons, Fluorinated; D011743:Pyrimidines; D007987:Gonadotropin-Releasing Hormone; C539351:elagolix
keywords: Elagolix; GnRH agonists; GnRH antagonists; endometriosis