Macimorelin

Macimorelin (INN) – or Macrilen (trade name) – is a drug that was developed by Aeterna Zentaris for use in the diagnosis of adult growth hormone deficiency.^[3] Macimorelin acetate, the salt formulation, is a synthetic growth hormone secretagogue receptor agonist.^[4] It is a growth hormone secretagogue receptor (ghrelin receptor) agonist, causing release of growth hormone from the pituitary gland.^[5][6][7] Macimorelin acetate is described chemically as D-Tryptophanamide, 2-methylalanyl-N-[(1R)-1-(formylamino)-2-(1H-indol-3-yl)ethyl]-acetate.

Macimorelin

Clinical data
Trade names	Macrilen
Other names	Aib-Trp-gTrp-CHO; AEZS-130; JMV 1843; Macimorelin acetate
AHFS/Drugs.com	Professional Drug Facts
License data	US DailyMed: Macimorelin
Routes of administration	By mouth
ATC code	V04CD06 (WHO)
Legal status
Legal status	US: ℞-only EU: Rx-only[1][2]
Pharmacokinetic data
Metabolism	Hepatic (CYP3A4-mediated)
Elimination half-life	4.1 hours
Identifiers
IUPAC name 2-Amino-N-[(2R)-1-[[(1R)-1-formamido-2-(1H-indol-3-yl)ethyl]amino]-3-1H-indol-3-yl)-1-oxopropan-2-yl]-2-methylpropanamide
CAS Number	381231-18-1 945212-59-9 (acetate)
PubChem CID	9804938
DrugBank	DB13074
ChemSpider	7980698
UNII	8680B21W73
KEGG	D10563 Y as salt: D10562 Y
ChEMBL	ChEMBL278623
CompTox Dashboard (EPA)	DTXSID601045766
Chemical and physical data
Formula	C26H30N6O3
Molar mass	474.565 g·mol−1
3D model (JSmol)	Interactive image
SMILES CC(C)(C(=O)N[C@H](CC1=CNC2=CC=CC=C21)C(=O)N[C@H](CC3=CNC4=CC=CC=C43)NC=O)N
InChI InChI=1S/C26H30N6O3/c1-26(2,27)25(35)31-22(11-16-13-28-20-9-5-3-7-18(16)20)24(34)32-23(30-15-33)12-17-14-29-21-10-6-4-8-19(17)21/h3-10,13-15,22-23,28-29H,11-12,27H2,1-2H3,(H,30,33)(H,31,35)(H,32,34)/t22-,23-/m1/s1 Key:UJVDJAPJQWZRFR-DHIUTWEWSA-N

Macimorelin (Macrilen) was invented and first synthesized at University of Montpellier, Centre National de la Recherche Scientitifique (CNRS), France.^[8][9][10] This transpired from a long-lasting research collaboration with Aeterna Zentaris. Aeterna Zentaris later in-licensed macimorelin as a development candidate from the CNRS and proceeded with the pre-clinical and clinical development of the compound.

As of January 2014, it was in Phase III clinical trials.^[11] The phase III trial for growth hormone deficiency is expected to be complete in December 2016.^[12]

As of December 2017, it was FDA-approved as a method to diagnose growth hormone deficiency.^[13][14] Traditionally, growth hormone deficiency was diagnosed via means of insulin tolerance test (IST) or glucagon stimulation test (GST). These two means are done parenterally, whereas Macrilen boasts an oral formulation for ease of administration for patients and providers.

The US Food and Drug Administration (FDA) considers it to be a first-in-class medication.^[15]

See also

• List of growth hormone secretagogues