Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain

被引:125
作者
Crosignani, PG
Luciano, A
Ray, A
Bergqvist, A
机构
[1] Pfizer Inc, New York, NY 10017 USA
[2] Karolinska Inst, Dept Obstet & Gynaecol, Danderyds Hosp, SE-18288 Stockholm, Sweden
[3] Univ Milan, Clin Ostet & Ginecol 1, I-20122 Milan, Italy
[4] Univ Connecticut, Sch Med, New Britain Gen Hosp, New Britain, CT 06050 USA
关键词
bone mineral density; depot medroxyprogesterone acetate; subcutaneous injection; endometriosis; leuprolide; pelvic pain;
D O I
10.1093/humrep/dei290
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BACKGROUND: A clinical study compared efficacy and safety of depot medroxyprogesterone acetate (DMPA) with leuprolide for endometriosis-associated pain. METHODS: This multicentre, 18 month, evaluator-blinded, comparator-controlled trial randomized 300 women with laparoscopically diagnosed endometriosis to 6 month treatment with subcutaneous injection of 104 mg/0.65 ml DMPA (DMPA-SC 104) every 3 months or leuprolide (3.75 mg monthly or 11.25 mg every 3 months), with 12 months post-treatment follow-up. Endpoints included patient response to treatment in five signs/symptoms (dysmenorrhoea, dyspareunia, pelvic pain, pelvic tenderness, induration) and changes in bone mineral density (BMD) and productivity at 6 and 18 months. RESULTS: DMPA-SC 104 and leuprolide produced equivalent (P < 0.02) reductions in at least four pain categories and significant (P < 0.001) improvements in composite score at months 6 and 18. At month 6, reductions in total hip and lumbar spine BMD were significantly less (P < 0.001) with DMPA-SC 104 versus leuprolide. BMD returned to pre-treatment levels 12 months post-treatment in the DMPA-SC 104 but not the leuprolide group. Total productivity also significantly (P <= 0.05) improved in both groups at 6 and 18 months. CONCLUSIONS: DMPA-SC 104 reduces endometriosis-associated pain as effectively as leuprolide and improves productivity with significantly less BMD decline.
引用
收藏
页码:248 / 256
页数:9
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