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prasterone (Mylis)

✓ Approved

Merck & Co. · AR · Small Molecule

What is prasterone?

prasterone is a small molecule developed by Merck & Co.. It is approved for therapeutic indications.

Drug Profile

Brand NamesMylis
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetAR
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

prasterone acts on 1 molecular target:

ARandrogen receptor (DHTR, AR8)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

prasterone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Surgical and medical proceduresLabour induction✓ Approved

Related Research Articles

PubMedBJOG : an international journal of obstetrics and gynaecology2026-11-08

Comparative Efficacy and Safety of Modern Treatment Modalities for Genitourinary Syndrome of Menopause: A Systematic Review and Network Meta-Analysis.

Randombage Prabath J S PJS, Akurugodagama Muthunu S MS

Genitourinary syndrome of menopause (GSM) is a chronic consequence of hypoestrogenism affecting vaginal, sexual and lower urinary tract health. Treatments include local vaginal oestrogen, intravaginal prasterone, oral ospemifene, hyaluronic acid preparations, moisturisers/lubricants and energy-based interventions, but comparative evidence is heterogeneous. To compare the relative efficacy and safety of contemporary GSM therapies using a systematic review and class-level network meta-analysis (NMA) of randomised controlled trials. MEDLINE/PubMed, Scopus, Cochrane CENTRAL, Web of Science, Google Scholar, ClinicalTrials.gov and WHO ICTRP were searched from inception to March 2026, with backward and forward citation searching. Randomised controlled trials enrolling postmenopausal women with symptomatic GSM or equivalent diagnoses. Two reviewers independently screened, extracted and linked reports from the same trial family and assessed RoB 2. The primary outcome was harmonised patient-reported symptom burden, using a prespecified hierarchy of global symptom score, most bothersome symptom, dyspareunia and vaginal dryness. A frequentist random-effects consistency NMA generated; Hedges g standardised mean differences (SMDs), 95% confidence intervals (CIs), prediction intervals and P-scores. Heterogeneity was estimated by REML; node splitting, a design-by-treatment interaction decomposition and sensitivity analyses assessed incoherence and influence. Confidence in all 21 network comparisons was evaluated with CINeMA using a validated percentage contribution matrix. Twenty-six efficacy publications represented 24 unique trial families and 4958 randomised participants after denominator adjudication. The primary symptom NMA included 15 trial families, seven nodes and 3415 participants. Versus placebo/sham/control, local vaginal oestrogen was the only class with a CI excluding the null (SMD 0.34, 95% CI 0.02-0.66). Estimates were imprecise for prasterone (0.37, -0.10 to 0.84), hyaluronic acid (0.31, -0.10 to 0.72), ospemifene (0.24, -0.38 to 0.87), moisturiser/lubricant (0.15, -0.37 to 0.67) and CO2 laser (0.03, -0.56 to 0.61). Heterogeneity remained material (τ2 = 0.097; I2 = 65.6%). Node splitting showed no statistically detectable local incoherence (all p ≥ 0.35) and the global design-by-treatment interaction decomposition was also non-significant (Q = 4.90, df = 3, p = 0.179). P-scores were similar for local oestrogen (0.704) and prasterone (0.704) and rankings were sensitivity-dependent. CINeMA confidence was low for local oestrogen versus placebo/sham/control and prasterone versus placebo/sham/control and very low for the remaining 19 network comparisons. Radiofrequency was not included in the primary symptom NMA because a hierarchy-compatible continuous symptom effect with extractable dispersion was unavailable. Overall RoB 2 was low for 2 trial families, some concerns for 11 and high for 11. Local vaginal oestrogen remains the best-supported benchmark for symptomatic GSM. Hyaluronic acid, prasterone and ospemifene have clinically relevant evidence, but cross-class estimates are imprecise and rankings are unstable. CO2 laser and radiofrequency should not be positioned as equivalent or superior first-line treatments on the available evidence. The data support individualised stepped care rather than a definitive treatment hierarchy. PROSPERO CRD420261332305.

PMID 43000041
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PubMedMaturitas2026-11-08

Dehydroepiandrosterone in menopausal medicine: From adrenal aging to intracrinology and personalised therapy.

Parra-Armendaris Manuel M MM, Parra-Yagnam Francisca S FS, Simoncini Tommaso T

Dehydroepiandrosterone and its sulfate are the most abundant circulating steroids in women, yet they have no high-affinity nuclear receptor of their own. Their physiological role is that of a precursor pool from which active androgens and estrogens are generated locally, within peripheral target cells, through the tissue-specific expression of steroidogenic enzymes-the process Labrie termed intracrinology. After menopause, when ovarian estrogen secretion ceases, essentially all estrogens and a large fraction of androgens acting on peripheral tissues derive from the intracrine conversion of adrenal dehydroepiandrosterone. Because adrenal dehydroepiandrosterone production declines progressively from the third decade of life (adrenopause), the menopausal woman faces a dual hormonal deficit: ovarian and adrenal. PubMed/MEDLINE, Embase and the Cochrane Library were searched for randomised trials, meta-analyses, mechanistic and pharmacokinetic studies, and current society position statements on dehydroepiandrosterone and prasterone in menopausal women, supplemented by hand-searching of key reference lists. This narrative review develops the intracrine framework as the conceptual bridge between adrenal aging and clinical therapeutics and critically appraises the evidence for two very different therapeutic strategies. Oral dehydroepiandrosterone, despite decades of investigation and a biologically coherent rationale, has not demonstrated convincing benefit on menopausal symptoms, sexual function, mood, bone or quality of life in women with normal adrenal function, and current guidelines do not endorse it. By contrast, intravaginal prasterone (6.5 mg dehydroepiandrosterone) exploits intracrinology at the level of a single estrogen- and androgen-responsive organ, improving the signs and symptoms of the genitourinary syndrome of menopause and moderate to severe dyspareunia while leaving serum sex-steroid levels within the normal postmenopausal range; it is approved by the United States Food and Drug Administration and the European Medicines Agency and is increasingly incorporated into international recommendations. We summarise the comparative evidence against other menopausal therapies, review the safety signal, contrast the positions of the major societies, and outline how biomarker-guided, intracrine-informed precision medicine might define the future role of dehydroepiandrosterone. The dehydroepiandrosterone story is, ultimately, one about where in the body a hormone should be made-and acted upon.

PMID 42998568
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PubMedBehavioural processes2026-11-05

Sex ratio allocation supports the Trivers-Willard hypothesis in Cervinae.

Lazar Petr P, Šárová Radka R, Pluháček Jan J

Adaptive secondary sex ratio allocation represents one of the most studied topics of behavioural ecology. Among many theories explaining this phenomenon, two are the most influential: Trivers-Willard hypothesis (TWH) and Local Resource Competition Model (LRCM). Despite many studies examining this topic, only a few of them focused on more than a single species. As natural history and social organisation among various species differ, different species might adapt different strategies in sex ratio adjustment. Therefore, we tested these hypotheses using data in five deer species born in six zoos - Père David's deer (Elaphurus davidianus, N = 377), elk (Cervus canadensis, N = 252), sika deer (Cervus nippon, N = 167), chital (Axis axis, N = 188) and reindeer (Rangifer tarandus, N = 371). We found that the overall secondary sex ratio did not differ from 1:1. In Cervinae, we found that the secondary sex ratio increased with increasing age of the mother corresponding with the TWH. On the other hand, in reindeer, we revealed the opposite results in line with LRCM. In addition, we found that in Père David's deer, and Vietnamese sika deer males were born earlier during the peak of the birth season than females. This result lends support to TWH as males born earlier could receive higher investment from mothers than those born later and this might affect their reproductive success in the future. Our study represents one of a few including several closely related mammalian species on this topic.

PMID 42988071
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PubMedJournal of neurological surgery reports2026-11-04

Delayed Posterior Choroidal Artery Aneurysm Formation and Rupture in a Postsuperior Temporal Artery to Middle Cerebral Artery Bypass Moyamoya Disease Patient.

Hsu William Wei WW, Soliven Ryerson Emil Magdaleno Rosario REMR, Igarashi Yutaka Y, Kanaya Takahiro T et al.

Background Moyamoya disease is a rare vascular disease that presents with stenosis of the internal carotid artery accompanied by formation of abnormal, fragile blood vessels at the base of the brain. This pathology often presents with aneurysms, which may cause ischemic or hemorrhagic complications. We present a case of posterior choroidal artery aneurysm in a moyamoya disease patient that ruptured following a 6-year asymptomatic period after the patient received superior temporal artery to middle cerebral artery bypass. Observations A 57-year-old female Japanese patient who received superficial temporal artery to middle cerebral artery bypass for moyamoya disease presented to the Nippon Medical School Hospital emergency room for sudden loss of consciousness after a 6-year asymptomatic period following her bypass procedure. She was diagnosed with left subcortical hemorrhage with ventricular rupture and hydrocephalus associated with a left medial posterior choroidal artery aneurysm. This was then subsequently managed with bilateral ventricular drainage, clipping, spinal drainage, and finally lumbar-peritoneal shunt. Conclusion Our case demonstrates delayed aneurysm formation at the posterior choroidal artery even after bypass surgery. Our patient's 6-year silent period after her bypass surgery highlights the need for long-term surveillance after the immediate postoperative period even if the patient is asymptomatic due to the possibility of chronic cerebrovascular changes following bypass that may go undetected.

PMID 42979662
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PubMedAdvances in simulation (London, England)2026-11-01

Beyond knowledge gains - learner experience and technology acceptance of virtual reality for anatomy education in Zambia: a randomized exploratory study.

Barteit Sandra S, El Ahmadie Nizar N, Nieder Jessica J, Andreadis Petros P

Standalone virtual reality (VR) enables interactive exploration of three-dimensional anatomy, but comparative evidence from resource-constrained medical-education settings remains limited. This study explored immediate knowledge outcomes, learner acceptance, and experiences with VR and three other learning resources in Zambia. In this four-arm randomized exploratory study, 67 first- and second-year Bachelor of Science in Clinical Sciences students were assigned using Excel-generated random group numbers (1-4; no allocation concealment) to standalone VR using 3D Organon, AMBOSS®, curated textbook materials, or self-directed internet search for a self-paced learning session of up to 30 min. Knowledge was assessed using an unvalidated 10-item pre-post test, and immediate acceptance was measured with an adapted Technology Acceptance Model questionnaire. The primary between-group knowledge analysis used baseline-adjusted analysis of covariance with HC3-robust standard errors. Acceptance comparisons were adjusted for multiple testing. Brief open-text responses underwent qualitative content analysis. A pre-study review indicated that tested concepts could be located in the three fixed-content resources but did not establish equivalence in depth, organisation, or accessibility, and could not be applied to the self-directed internet group. The knowledge analysis included 59 participants (VR n = 12; AMBOSS® n = 17; textbook n = 16; Internet n = 14). Within-group increases reached the adjusted significance threshold in the AMBOSS®, textbook, and web-resource groups but not in the VR group (adjusted p = .053). The primary analysis did not detect an overall difference in baseline-adjusted post-test scores between modalities, F(3,54) = 1.945, p = .133; none of the six pairwise comparisons was significant after Holm adjustment. This finding does not establish equivalence. Acceptance analyses included 55-60 participants per construct. After adjustment across six domains, only Attitude differed significantly between modalities, H(3) = 11.801, ε² = 0.17, adjusted p = .049; AMBOSS® was rated more favourably than the self-directed internet search (adjusted p = .019, Cliff's δ = -0.60). Perceived ease of use and perceived enjoyment showed low internal consistency, limiting their interpretation. The qualitative corpus comprised 211 comments from 64 participants. Some VR participants valued visualisation, novelty, and enjoyment but reported navigation and content-access difficulties. AMBOSS® participants frequently valued organisation and accessibility, while experiences with textbook and web resources were mixed. This small exploratory study did not provide conclusive evidence of differences in immediate knowledge outcomes between the four modalities. Quantitative acceptance differences were also limited after adjustment for multiple comparisons. The findings identify content accessibility, curricular alignment, interface familiarization, and exposure time as priorities for larger, prospectively designed studies using validated instruments and longer-term outcomes.

PMID 42966864
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PubMedAnimals : an open access journal from MDPI2026-10-27

Serum Amyloid A as an Inflammatory Biomarker in Captive Japanese Sika Deer (Cervus nippon): Reference Intervals and Correlations with Hematological and Serum Biochemical Parameters.

Ito Ayaka A, Sakurai Hiroko H, Maetani Fumie F, Asai Takayuki T et al.

Serum amyloid A (SAA) is a major acute phase protein that increases rapidly during inflammation, infection, and tissue injury, but data on SAA in Japanese sika deer (Cervus nippon) remain limited. SAA concentrations were measured in 128 serum samples from 84 captive Japanese sika deer (Mageshima sika deer, n = 26; Formosan sika deer, n = 44; mixed-subspecies individuals, n = 14) at Kagoshima City Hirakawa Zoological Park, Japan, using two latex agglutination turbidimetric immunoassays, VET-SAA, and LZ-SAA. Reference intervals were established, and Spearman rank correlations were evaluated between SAA and hematological and serum biochemical parameters. SAA concentrations were also compared between healthy (n = 30) and diseased (n = 95) groups, and receiver operating characteristic (ROC) analysis determined optimal cutoff values. Reference intervals for VET-SAA and LZ-SAA were 0.00-6.73 mg/L and 0.00-0.96 mg/L, respectively. Both assays correlated significantly with total protein, globulin, albumin, the albumin-to-globulin ratio, band and segmented neutrophils, lymphocytes, and eosinophils. SAA concentrations were also significantly higher in diseased than healthy deer (p < 0.001). The area under the ROC curve was 0.972 for VET-SAA and 0.959 for LZ-SAA. These findings suggest that SAA reflects inflammatory status in Japanese sika deer and may serve as a useful supplementary biomarker for inflammatory assessment in this species.

PMID 42939091
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