Add-back therapy in the treatment of endometriosis-associated pain.

Abstract

OBJECTIVE:

To determine the efficacy of GnRH analogue plus add-back therapy compared with GnRH analogue alone and estroprogestin in patients with relapse of endometriosis-associated pain.

DESIGN:

Randomized, controlled study.

SETTING:

University hospital.

PATIENT(S):

One hundred thirty-three women with relapse of endometriosis-related pain after previous endometriosis surgery.

INTERVENTION(S):

Forty-six women were treated with GnRH analogue plus add-back therapy, 44 women were given GnRH analogue alone, and 43 women received estroprogestin, for 12 months.

MAIN OUTCOME MEASURE(S):

Pain evaluation by a visual analogue scale, quality of life in treated patients according to the SF-36 questionnaire, and occurrence of adverse effects, including bone mass density loss, at pretreatment, after 6 months of treatment, at the end of treatment (12 months), and 6 months after discontinuation of treatment.

RESULT(S):

Patients treated either with GnRH analogue alone or GnRH analogue plus add-back therapy showed a higher reduction of pelvic pain, dysmenorrhea, and dyspareunia than patients treated with oral contraceptive, whereas patients treated with add-back therapy showed a better quality of life, as assessed with the SF-36 questionnaire, and adverse effects rate than the other two groups.

CONCLUSION(S):

Add-back therapy allows the treatment of women with relapse of endometriosis-associated pain for a longer period, with reduced bone mineral density loss, good control of pain symptoms, and better patient quality of life compared with GnRH analogue alone or oral contraceptive.

• Authors: Errico Zupi, Daniela Marconi, Marco Sbracia, Fulvio Zullo, Bonaventura De Vivo, Caterina Exacustos, Giuseppe Sorrenti
• Journal: Fertility and sterility (Fertil Steril) Vol. 82 Issue 5 Pg. 1303-8 (Nov 2004) ISSN: 0015-0282 [Print] United States
• PMID: 15533351 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Contraceptives, Oral
• Drug Combinations
• Norpregnenes
• estroprogestin
• Gonadotropin-Releasing Hormone
• Ethinyl Estradiol

Topics

• Adult
• Bone Density (drug effects)
• Contraceptives, Oral (adverse effects, therapeutic use)
• Drug Administration Schedule
• Drug Combinations
• Drug Therapy, Combination
• Dysmenorrhea (etiology, physiopathology)
• Dyspareunia (etiology, physiopathology)
• Endometriosis (complications, drug therapy, physiopathology, surgery)
• Ethinyl Estradiol (administration & dosage, adverse effects, therapeutic use)
• Female
• Gonadotropin-Releasing Hormone (analogs & derivatives)
• Humans
• Norpregnenes (administration & dosage, adverse effects, therapeutic use)
• Pain Measurement
• Palliative Care
• Pelvic Pain (etiology, physiopathology)
• Quality of Life
• Recurrence
• Surveys and Questionnaires