Gonadotropin Releasing Hormone (GnRH) Analogues

The gonadotropin releasing hormone (GnRH) agonists and antagonists are short peptide analogues of GnRH that cause a profound inhibition of estrogen and androgen synthesis and are used predominantly as androgen deprivation therapy of advanced prostate cancer. Some of these agents are also used to treat benign conditions responsive to hormonal inhibition such as endometriosis, uterine fibroids, precocious puberty and infertility. Leuprolide, goserelin, triptorelin and histrelin are considered GnRH agonists, whereas degarelix acts predominantly as an antagonist. Several of the GnRH analogues have been reported to be associated with transient serum enzyme elevations during therapy, but none have been convincingly implicated in causing clinically significant liver injury with jaundice.