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Fluasterone is a synthetic fluorinated analogue of dehydroepiandrosterone (DHEA) developed to retain the beneficial anti-inflammatory and metabolic effects of DHEA while minimizing its androgenic and estrogenic side effects. It acts primarily as a potent uncompetitive inhibitor of glucose-6-phosphate dehydrogenase (G6PDH), with additional proposed mechanisms including inhibition of NF-kB activation and reduction of oxidative stress. Fluasterone has demonstrated anti-inflammatory, antihyperglycemic, antihyperlipidemic, chemopreventive, and immunomodulatory activities in preclinical models. Unlike DHEA, it does not convert into sex hormones due to steric hindrance from the fluorine atom at C16α. The drug has been investigated for multiple indications such as Cushing's syndrome (including hyperglycemia), nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), obesity, cancer/tumors, psoriasis/psoriatic disorders, rheumatoid arthritis, asthma, lupus erythematosus and metabolic syndrome. Orphan drug designation was granted for Cushing's syndrome and related metabolic conditions[1][2][4][5][7].
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