Dienogest as effective as leuprolide acetate for treating endometriosis pain
MedWire News: Dienogest is as effective as leuprolide acetate (LA) for treating endometriosis-associated pain, but has significantly less impact on bone mineral density (BMD) and estradiol levels, show study findings.
Gonadotrophin-releasing hormone agonists such as LA are widely considered the treatment of choice for endometriosis-associated pain, but are associated with symptoms of estrogen deprivation and bone demineralization, say Thomas Strowitzki (University of Heidelberg, Germany) and co-authors.
The researchers randomly assigned 229 women with confirmed endometriosis to receive treatment with dienogest (2 mg/day, orally) or LA (3.75 mg depot injection every 4 weeks) for 24 weeks.
The absolute reduction in pelvic pain from baseline to end of treatment, as measured by the Visual Analogue Scale, was similar between women receiving dienogest (47.5 mm) and those receiving LA (46.0 mm).
BMD assessment in a subgroup of 57 women at baseline and final visit showed that women taking dienogest had a 0.25 percent increase in BMD compared with a 4.04 percent decrease for those receiving LA.
In addition, mean levels of serum estradiol remained constant during dienogest treatment (256.3 to 249.9 pmol/l), while a pronounced decrease was seen with LA (299.0 to 68.5 pmol/l). Women taking dienogest reported significantly fewer days with hot flashes by week 24 compared with those taking LA, at 0.82 versus 4.70 days per week.
The researchers conclude that “dienogest may offer an effective and well-tolerated treatment in endometriosis.”
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By Ingrid Grasmo