WhelWomen's Health Evidence Lab
WHEL-C-018 · Emerging evidence · 4.5/10

Elagolix Sodium for endometriosis

Elagolix sodium is an approved GnRH receptor antagonist indicated for endometriosis per Open Targets annotation.

Origin · Existing drug · repurposing candidatePathway · 505(b)(2) · existing active ingredient, new indicationEvidence arm · Pathway insightsEvidence supports
How to read thisThe summary above and the proposed mechanism are generated by the model from the sources it ingested, and are written as the model’s reasoning rather than established fact. Any figure quoted from MATRIX is a model-derived association score, not a clinical measurement. How far the published record backs this pair is carried by the score’s own rigor dimension and traced to verbatim sources at the foot of the page.

Hypothesized mechanism

By antagonizing the gonadotropin-releasing hormone receptor, elagolix suppresses gonadotropin and downstream estrogen production, reducing estrogen-driven endometriotic lesion activity.

This is the model’s proposed mechanism from the sources on file, not a demonstrated causal pathway. How well the published record supports it is reflected in the rigor and plausibility dimensions of the score, and traced to the verbatim sources at the foot of the page.

How the score was reached, for this pair

The composite score is the sum of five dimensions, each scored 0 to 2 by the model from the evidence on file. Below is the sub-score this specific pair received on each, with what that dimension measures. It scored 4.5 of 10 overall, a emerging reading, from a pathway rated emerging in strength.

The model’s overall reasoning for this pair is the summary at the top of the page, and the mechanism it proposed is in the section above.

Pathway arm · anchors the headline4.5 / 10 · Emerging

Scored for women. Female representation not stated — applicability to women uncertain (flagged for full text). (band F4, ×0.75).

Corroboration

Only a single line of evidence is provided: an Open Targets annotation that elagolix sodium is a GnRH receptor antagonist approved for endometriosis. No independent mechanistic studies or converging pathways are cited.

0 / 2

Rigor

The claim derives from a curated database (Open Targets) reflecting an approved clinical-stage drug, which implies human-relevant evidence, but no actual model, trial, or experimental data is shown to gauge strength or recency.

1 / 2

Specificity

The claim explicitly names the drug's mechanism as a Gonadotropin-releasing hormone receptor antagonist acting on the GnRH receptor target, indicating a well-defined and specific drug-target interaction.

2 / 2

Plausibility

GnRH receptor antagonism suppresses estrogen production, directly fitting the estrogen-dependent pathophysiology of endometriosis; the drug is listed at maximum clinical stage APPROVAL, supporting strong target-phenotype fit.

2 / 2

Consistency

The single claim is internally consistent (antagonist mechanism appropriate for the condition), but with only one signal there is no opportunity to assess agreement across multiple mechanistic lines.

1 / 2
How the scoring rubric works, in general

Regulatory & development status

Where this candidate sits in the US regulatory landscape: whether the drug is already FDA-approved for endometriosis (on-label) or approved for something else (off-label), whether the molecule is available as a generic or a single-source brand still under patent, and how far it has been studied as a therapy for this condition. Each fact is drawn from a public US source and reported beside the score; none of it is folded into the score.

This is descriptive context, not regulatory advice. It maps the landscape a 505(b)(2)route would build on (an already-approved active ingredient proposed for a new indication), but it is not a 505(b)(2) viability assessment, and says nothing about whether any particular development path is advisable. “Approved” means FDA-approved (US); approvals elsewhere are out of scope.

Approval relationship On-label (FDA-approved for this use)

Read from the drug’s FDA label via DailyMed, the US National Library of Medicine’s label repository. A label is only counted when it carries an FDA-approved marketing category (an NDA, ANDA, or biologic BLA); dietary supplements, homeopathics, and OTC-monograph products are not FDA-approved drugs and are excluded.

For this pair. This condition appears in the drug's FDA-approved label (Indications & Usage), so using it here is an approved, on-label use.

From the label’s Indications & Usage section: “USAGE ORILISSA is indicated for the management of moderate to severe pain associated with endometriosis. Limitation s of Use: Limit the duration of use based on the dose and coexisting condition (see, ORILISSA (ELAGOLIX) TABLET, FILM COATED [ABBVIE INC.] · view label ↗

Generic & patent supply Brand-only, patent-protected

Read from the FDA Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), using single-ingredient products only so that patents on novel branded combination formulations are never attributed to the base molecule.

For this molecule. Single-source brand with at least one unexpired Orange Book patent (latest listed expiry Aug 2040).

Latest listed Orange Book patent expiry: Aug 2040. Patent listings can change and do not by themselves determine when a generic may launch.

ORILISSA · NDA (brand) · EQ 150MG BASE · rx · approved Jul 23, 2018
ORILISSA · NDA (brand) · EQ 200MG BASE · rx · approved Jul 23, 2018

Clinical-trial stage, for this condition Phase 3

Read from ClinicalTrials.gov (US National Library of Medicine). A trial only counts when the drug appears as an experimental or active-comparator intervention in an interventional study of this condition; mechanistic, drug-interaction, post-marketing (Phase 4), and comparator-background uses are excluded, so this reflects the drug being tested as a therapy for endometriosis.

For this pair. Studied in 7 qualifying interventional trials · highest stage reached Phase 3 · completed.

NCT01760954 · Phase 3 · completed
NCT02143713 · Phase 3 · completed
NCT01620528 · Phase 3 · completed
NCT01931670 · Phase 3 · completed
The regulatory and trial sources this status is drawn from

Layers not covered for this pair

Sex-specific pharmacokineticsNone on file

Not covered for this pair. This layer holds documented sex-specific pharmacokinetics for a limited set of drugs, and this compound is not among them yet. A blank here means the drug is not covered by the layer, not that no sex difference exists.

More on the sex-specific pharmacokinetics layer and its sources
Cycle-phase dependenceNone on file

Not covered for this pair. The cycle-phase layer is seeded for the strongest-evidence cases so far (PMDD), and this pair is not among them yet. A blank here means the pair is not covered by the layer, not that the effect was found to be phase-independent.

More on the cycle-phase layer and its sources

Source evidence · what the pipeline ingested

These are the sources the pipeline ingested to detect and score this signal, the published literature the model actually read, each tagged by study type. Where the model combined findings the claim is marked as a synthesis (S), and where the literature disagrees the contradiction is shown (!).

Every source below belongs to this signal’s evidence arm, Pathway insights. Whel reads each drug-condition pair through four such arms, each held to its own inclusion bar; a signal is surfaced through one of them.

  • 1Per Open Targets (retrieved 2026-06-16), ELAGOLIX SODIUM (a Small molecule) is a clinical candidate for endometriosis (maximum clinical stage APPROVAL); its mechanism of action is Gonadotropin-releasing hormone receptor antagonist on target gonadotropin releasing hormone receptor. Open Targets · mechanistic

These are the verbatim sources the pipeline surfaced and read; they may not be the full published record for a pair, and the score reflects the strength and agreement of the evidence rather than its volume. The strength of these source types is what the rigor dimension of the score reads off. MATRIX, sex-specific pharmacokinetics, and cycle phase are separate layers the pipeline does not ingest, external cross-references reported beside the score, and they link to their own sources in their sections above.

The primary sources and pipelines this evidence is drawn from