Anastrazole and oral contraceptives: a novel treatment for endometriosis

被引:170
作者
Amsterdam, LL
Gentry, W
Jobanputra, S
Wolf, M
Rubin, SD
Bulun, SE
机构
[1] Indiana Univ, Sch Med, Indianapolis, IN 46204 USA
[2] Univ Illinois, Chicago Sch Med, Chicago, IL 60680 USA
[3] AstraZeneca Pharmaceut, Wilmington, DE USA
[4] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
关键词
anastrazole (Arimidex); aromatic inhibitors; endometriosis; pelvic pain;
D O I
10.1016/j.fertnstert.2005.02.018
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To establish the use of aromatase inhibitors as a therapeutic option for endometriosis. Design: Prospective open-label Food and Drug Administration phase 2 trial with Institutional Review Board approval. Setting: Outpatient tertiary care centers. Patient(s): Fifteen premenopausal patients with documented refractory endometriosis and chronic pelvic pain. Intervention(s): After a 1-month washout of endometriosis hormone therapies, women took 1 mg anastrazole (Arimedex; AstraZeneca, Wilmington, DE) and one tablet of 20 mu g ethinyl astradiol/0.1 mg levonorgestrel (Aless; Wyeth, Madison, NJ) daily for 6 months. Main Outcome Measure(s): An analog pain scale recorded pelvic pain in daily diaries and surveys at baseline and after each treatment month. Side effects, blood counts, liver and renal functions, cholesterol levels, and bone density were monitored. Result(s): Fourteen of 15 patients achieved significant pain reduction. Median pain scores decreased 55% after 6 months, while mean pain scores decreased 40%. Pain reduction comparing each treatment month to baseline achieved statistical significance. Average pain scores began dropping after only 1 treatment month and continued decreasing each additional month. No organ system experienced adverse effects. Estradiol level were suppressed during treatment. Side effects were mild and improved over time. Conclusion(s): Fourteen of 15 patients with refractory endometriosis achieved significant pain relief using anastrazole and 20 mu g ethinyl estradiol/0.1 mg levonorgestrel with minimal side effects. This treatments for endometriosis is a promising new modality that warrants further investigation.
引用
收藏
页码:300 / 304
页数:5
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