What strategy has been developed to mitigate relugolix-induced BMD loss?

Label:chem

Topic
Prolonged estrogen deprivation leads to unacceptable bone loss, so add-back hormone therapy is required for long-term use of GnRH antagonists.
Answer
A once-daily combination tablet containing 40 mg relugolix, 1 mg estradiol (E2), and 0.5 mg norethisterone acetate (NETA) was formulated. The low-dose E2 replaces enough estrogen to protect bone, while NETA provides endometrial protection against unopposed estrogen stimulation.
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