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Pyrilutamide

Chemical compound From Wikipedia, the free encyclopedia

Pyrilutamide
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Pyrilutamide (developmental code name KX-826) is a nonsteroidal antiandrogen (NSAA) – specifically, a selective high-affinity silent antagonist of the androgen receptor (AR) – which is under development by Suzhou Kintor Pharmaceuticals, inc., a subsidiary of Kintor Pharmaceutical Limited, for the potential treatment of androgenic alopecia (androgen-dependent scalp hair loss)[2][3][4] As of September 2022, it is in phase 3 clinical trials for androgenic alopecia and phase 2 trials for acne.[3]

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Development

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Pyrilutamide has undergone several clinical trials for the treatment of androgenic alopecia (AGA) in both males and females.[5] The primary endpoint for most trials was the change from baseline in non-vellus target area hair count (TAHC) compared to placebo after 24 weeks of treatment.[5]

Phase II Trials

Male AGA in China

A phase II trial in China enrolled 120 male patients, randomized into four groups: KX-826 0.25% BID (twice daily), KX-826 0.5% QD (once daily), KX-826 0.5% BID, and placebo. After 24 weeks, the 0.5% BID group showed significant improvement:[5]

  • Non-vellus target area hair count (TAHC) increased by 22.73 hair counts per cm² from baseline (P<0.001)
  • TAHC increased by 15.34 hair counts per cm² compared to placebo (P=0.024)

Female AGA in China

A phase II trial for female AGA in China included 160 patients in five groups: KX-826 0.25% QD, 0.25% BID, 0.5% QD, 0.5% BID, and placebo. After 24 weeks:[5]

  • The 0.5% QD group showed an increase of 11.39 hair counts per cm² compared to placebo (P=0.0087)
  • Efficacy was observed as early as 12 weeks

Male AGA in the U.S.

A phase II trial in the U.S. enrolled 123 male patients, divided into KX-826 0.25% QD, 0.5% QD, 0.5% BID, and placebo groups. Results after 24 weeks showed:[5]

  • The 0.5% BID group increased by approximately 10 hair counts per cm² from baseline (P=0.0088)
  • A dose-response relationship was observed across different dosage groups

Phase III Trials

Male AGA in China

A phase III trial for male AGA in China enrolled 740 patients, randomized into KX-826 0.5% BID and placebo groups. Results announced on November 27, 2023, showed:[5]

  • KX-826 promoted hair growth compared to baseline with statistical significance (P<0.0001)
  • Improvement in TAHC at all visit points compared to placebo, though without statistical significance

Ongoing Studies

  • A long-term safety phase III trial for AGA treatment in China, enrolling 271 male and female patients for a 52-week treatment period, focusing on treatment-emerged adverse events (TEAE).[5]
  • A phase Ib/III clinical trial of KX-826 in combination with minoxidil for male AGA in China, approved by NMPA on February 1, 2024.[5]

Availability as a Cosmetic Product

In addition to its ongoing clinical development, Pyrilutamide has been introduced to the market as a cosmetic anti-hair loss product under the brand name Koshine. This approach allows it to be made available to consumers without the need for full regulatory approval as a medical treatment. Its classification as a cosmetic reflects a strategic decision to facilitate earlier access while formal medical approval is still pending.[6]

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Adverse effects

Pyrilutamide is generally well-tolerated. The most common adverse event is contact dermatitis.[7]

Across all trials, KX-826 demonstrated a favorable safety profile:[5]

  • No serious adverse events (SAE) or adverse drug reactions (ADR) were reported
  • Most treatment-emerged adverse events (TEAE) were mild and similar to placebo
  • Low systemic exposure was observed after topical application

Pharmacology

Thumb
Plasma concentration of pyrilutamide and metabolite KX-982 in different dose groups in phase Ib clinical trials in China

Pharmacodynamics

Pyrilutamide binds to the androgen receptor with a very high affinity with an IC50 of 0.28 nM.[4] Reference drug bicalutamide had an IC50 of 3.1 nM.[4]

See also

References

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