Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis.

Abstract

INTRODUCTION:

The second-line treatment of endometriosis-related pain symptoms includes injectable depot formulations of gonadotropin-releasing hormone analogs (GnRH-as). These drugs improve the symptomatology by inducing a hypoestrogenic status and a consequent regression of endometriotic implants. However, GnRH-a may cause a not negligible rate of adverse events, in particular vasomotor symptoms and bone mineral density loss, that may limit patients' adherence and safety on long-term treatment. Several strategies have been suggested to improve the compliance to treatment.

AREAS COVERED:

This narrative review aims to give an overview of the safety and tolerability of GnRH-a therapy and to present the different options of steroidal and non-steroidal add-back therapies in order to reduce the hypoestrogenic side effects.

EXPERT OPINION:

Side effects of long term GnRH-a treatment are particularly relevant. Although it has been known the efficacy of GnRH-as for treating endometriosis-associated pain, the best schedules of therapy in terms of duration and dosages are still to be defined. The ideal treatment schedule of GnRH-a is still a matter of debate as to the optimal add-back combination.

• Authors: Luigi Della Corte, Fabio Barra, Antonio Mercorio, Giulio Evangelisti, Agnese Maria Chiara Rapisarda, Simone Ferrero, Giuseppe Bifulco, Pierluigi Giampaolino
• Journal: Expert opinion on drug metabolism & toxicology (Expert Opin Drug Metab Toxicol) Vol. 16 Issue 9 Pg. 759-768 (Sep 2020) ISSN: 1744-7607 [Electronic] England
• PMID: 32597340 (Publication Type: Journal Article, Review)

Chemical References

• Steroids
• Gonadotropin-Releasing Hormone

Topics

• Animals
• Bone Density (drug effects)
• Endometriosis (drug therapy)
• Female
• Gonadotropin-Releasing Hormone (adverse effects, analogs & derivatives)
• Humans
• Medication Adherence
• Steroids (administration & dosage)
• Vasomotor System (drug effects)