Melanocortin receptor agonists: approved indications and supplied uses
What is the relationship between the indications in which melanocortin receptor agonists have been evaluated and the uses under which they are supplied?
§1Abstract
§1.1Review question
What is the relationship between the indications in which melanocortin receptor agonists have been evaluated and the uses under which they are supplied?
§1.2PICO frame
Table 1. The registered PICO frame. Any change made after protocol registration is recorded in the amendment log at §5 and is identified there as post hoc.
| Element | As registered |
|---|---|
| Population | Adults. |
| Intervention | Bremelanotide, afamelanotide or an unapproved melanocortin agonist analogue. |
| Comparator | Placebo. |
| Outcomes | The indication studied; the effect size where established; the uses under which the compound is supplied. |
§1.3Method in brief
A structured map of the available evidence for a question where the Institute judges that a quantitative synthesis is not yet supportable. A scoping review states what would have to exist before an intervention review could be attempted. The protocol was registered with the Institute's secretariat before the search was executed. The search was run on 11 March 2024 across 8 sources and is reproduced in full at §2. Screening, extraction and certainty assessment were performed independently by two members of the secretariat with disagreement resolved by a third.
§1.4Conclusion
Low certainty evidence bears on the supplied uses. One compound in this group holds an approval on the basis of two randomised trials reporting a statistically significant but numerically small effect. A second compound in the group has no approval anywhere, no completed controlled trial, and a documented association with melanocytic change and with a systemic reaction syndrome. The Institute records that the two are frequently discussed as though they were interchangeable and that they are not.
The conclusion rests on 2 contributing studies, listed with their extracted data at §3 and summarised outcome by outcome at §4.
§1.5Limitations
§1.6Consultation
This review was released for public comment before ratification. Draft scoping review: melanocortin receptor agonists received 11 submissions. Amendments arising are recorded in the amendment log and are traceable to a numbered submission.