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著者: Jo Kitawaki, Izumi Kusuki, Kaoruko Yamanaka, Izumi Suganuma
雑誌名: Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):212-6. doi: 10.1016/j.ejogrb.2011.03.012. Epub 2011 Apr 6.
Abstract/Text
OBJECTIVE: To examine whether long-term administration of dienogest following gonadotropin-releasing hormone agonist (GnRH-a) therapy would prolong the relief of pelvic pain while reducing the amount of irregular uterine bleeding.
STUDY DESIGN: This was a prospective, non-randomized clinical trial. Among the patients suffering from chronic pelvic pain associated with recurrent endometriosis, Group G (n=38) received GnRH-a for 4-6 months and then dienogest (1 mg/day) for 12 months. The dose of dienogest was increased to 1.5 or 2 mg/day when a patient had uncontrollable uterine bleeding {n=15 (39%)}. Group D (n=33) received only dienogest (2 mg/day) for 12 months. Pelvic pain was assessed using a visual analog scale (VAS). Uterine bleeding was semi-quantified using a pictorial blood loss assessment chart (PBAC).
RESULTS: In Group G, GnRH-a significantly reduced the VAS score for pelvic pain, and alleviation was maintained during the 12-month therapy with dienogest. There was no significant difference in pain reduction between Group G and Group D. The PBAC score during the first 6 months on dienogest was significantly smaller in Group G than in Group D.
CONCLUSION: Treatment with a GnRH-a followed by long-term dienogest therapy maintains the relief of endometriosis-associated pelvic pain achieved with GnRH-a therapy for at least 12 months. This regimen reduces the amount of irregular uterine bleeding that often occurs during the early phase of dienogest therapy.
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
PMID 21474232 Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):212-6. doi: 10.1016/j.ejogrb.2011.03.012. Epub 2011 Apr 6.
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