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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · evidence extract

PT-141 (bremelanotide) in hypoactive sexual desire and erectile dysfunction — evidence extract

The Institute's graded assessment of PT-141 (bremelanotide) for hypoactive sexual desire and erectile dysfunction, with the contributing trials and the domain-by-domain certainty reasoning.

Document identifier
CEI-MN-048/EV-SEXUAL-DYSFUNCTION
Series
Evidence extract
Version
4.1
Published
15 May 2023
Last reviewed
15 Aug 2024
Next review
15 Aug 2026
Identifier
10.71829/cei.mono.48
Certainty
Moderate
Cycle
2023 Q2

§1Evidence extract: Hypoactive sexual desire and erectile dysfunction

§1.1Question and anchor outcome

Population
Persistently reduced sexual desire or impaired erectile function causing distress, assessed by validated instruments.
Intervention
PT-141 (bremelanotide), subcutaneous, on demand
Comparator
As used in each contributing trial; reported per trial rather than pooled across comparator types
Anchor outcome
Female Sexual Function Index desire domain

Additional outcomes the Institute extracts for this indication: Female Sexual Distress Scale item 13; International Index of Erectile Function; Satisfying sexual events.

§1.2Contributing trials

Table 1. Trials contributing to the assessment of PT-141 (bremelanotide) in hypoactive sexual desire and erectile dysfunction.

TrialPhaseDesignRandomisedDurationYear
RECONNECT-3013Randomised, double-blind, placebo-controlled62624 weeks2019
RECONNECT-3023Randomised, double-blind, placebo-controlled63024 weeks2019

§1.3Certainty assessment

Certainty assessment by domainDowngrading decision recorded for each certainty domain.Certainty domainNo concernSeriousVery seriousEffect on ratingRisk of biasdowngrade one levelInconsistencyno downgradeIndirectnessno downgradeImprecisionno downgradePublication biasno downgradeTotal downgrading: 1 levelModerate certainty
Figure 2. Domain-by-domain certainty assessment for PT-141 (bremelanotide) in hypoactive sexual desire and erectile dysfunction. The starting rating for a body of randomised evidence is high; each serious concern reduces it by one level and each very serious concern by two.

Table 2. Reasoning recorded against each certainty domain.

DomainRatingReasoning
Risk of biasSeriousDifferential attrition exceeded the pre-specified threshold in one arm.
InconsistencyNo concernNo serious concern identified in this domain.
IndirectnessNo concernNo serious concern identified in this domain.
ImprecisionNo concernNo serious concern identified in this domain.
Publication biasNo concernNo serious concern identified in this domain.
Overall rating: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate.

§1.4What this extract does not establish

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Clayton AH, Althof SE, Kingsberg S, DeRogatis LR, Kroll R, Goldstein I, Kaminetsky J, Spana C, Lucas J, Jordan R, Portman DJ. Bremelanotide for female sexual dysfunctions in premenopausal women: a randomized, placebo-controlled dose-finding trial. Women’s Health 2016;12(3):325–337. doi:10.2217/whe-2016-0018 · PMID 27638896
  2. D’Hondt M, Bracke N, Taevernier L, Gevaert B, Verbeke F, Wynendaele E, De Spiegeleer B. Related impurities in peptide medicines. Journal of Pharmaceutical and Biomedical Analysis 2014;101:2–30. doi:10.1016/j.jpba.2014.06.012 · PMID 25044089
  3. Manning MC, Chou DK, Murphy BM, Payne RW, Katayama DS. Stability of protein pharmaceuticals: an update. Pharmaceutical Research 2010;27(4):544–575. doi:10.1007/s11095-009-0045-6 · PMID 20143256

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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