Corticorelin ovine triflutate

Summary

Corticorelin ovine triflutate (Acthrel) is a synthetic form of ovine corticotropin-releasing hormone used as a diagnostic agent to distinguish pituitary-dependent Cushing's disease from ectopic ACTH syndrome and adrenal tumors. It stimulates pituitary ACTH secretion and is administered as an intravenous injection for the differential diagnosis of ACTH-dependent hypercortisolism.

Mechanism of Action

Synthetic ovine corticotropin-releasing hormone (oCRH) that binds to CRH receptors on pituitary corticotroph cells, stimulating the synthesis and release of adrenocorticotropic hormone (ACTH) and beta-endorphin. Used diagnostically to differentiate the source of excess ACTH production.

Routes of Administration

Goals & Uses

• Differential diagnosis of Cushing's syndromeDiagnosticHigh
• Inferior petrosal sinus sampling (IPSS) adjunctDiagnosticHigh
• Evaluation of hypothalamic-pituitary-adrenal (HPA) axis functionDiagnosticModerate

Contraindications

• Concurrent heparin administrationDrug InteractionModerate
• Hypersensitivity to corticorelin or ovine proteinsAllergy/ImmunologyHigh

Adverse Effects

• AnaphylaxisImmunologicRareSevere life-threatening allergic reaction
• Facial flushingCardiovascular/DermatologicCommon
• Injection site reactionsLocalUncommon
• HypotensionCardiovascularUncommonLow blood pressure
• TachycardiaCardiovascularUncommonAbnormally fast heart rate
• DyspneaRespiratoryRareShortness of breath

Drug Interactions

• HeparinModerate
• Glucocorticoids (exogenous)Moderate
• MetyraponeLow

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patientsAgeRelative
• Patients with known allergy to ovine proteinsAllergyAbsolute

Regulatory Status

• European UnionUnknownNot widely marketed in EU; human CRH (corticorelin human, CRH-Ferring) is used in some European countries for similar diagnostic purposes.
• United StatesApprovedApproved: Differential diagnosis of ACTH-dependent Cushing's syndrome (pituitary vs. ectopic ACTH production)FDA-approved under NDA; marketed as Acthrel by Ferring Pharmaceuticals. Orphan drug designation.
• United KingdomUnknownHuman sequence CRH preparations may be preferred in the UK; availability of ovine formulation is limited.

FDA-approved in the United States for diagnostic use in differentiating pituitary and ectopic production of ACTH in patients with ACTH-dependent Cushing's syndrome.

Evidence & Sources

No sources recorded yet.