Levonorgestrel-releasing intrauterine system versus conventional medical therapy for heavy menstrual bleeding in the Asia-Pacific region.

Abstract

OBJECTIVE:

To compare clinical outcomes, including cumulative continuation rate (CCR), in the treatment of idiopathic heavy menstrual bleeding (HMB) with the levonorgestrel-releasing intrauterine system (LNG-IUS) and with conventional medical therapies (CMTs), including combined oral contraceptives, oral progestins, and antifibrinolytics, either alone or in combination, in the Asia-Pacific region.

METHODS:

In a prospective observational cohort study conducted between September 2008 and December 2010, 647 women (LNG-IUS, n=483; CMTs, n=164), aged 18-45 years and diagnosed with HMB, were recruited from 8 countries and followed for up to 1 year. The primary outcome was the CCR at 12 months. Secondary outcomes included bleeding pattern, an assessment of treatment efficacy by the treating physician, and safety.

RESULTS:

The CCR at 12 months was significantly higher for LNG-IUS than for CMTs (87.6% vs 56.3% P<0.05). Compared with CMTs, LNG-IUS offered a better reduction in both subjectively assessed menstrual blood loss and the number of bleeding days, and had better efficacy for HMB, as determined by the physician's final evaluation.

CONCLUSION:

The present study provides information on the real-life patterns of treatment of HMB in the Asia-Pacific region. The efficacy of CMTs was inferior compared with LNG-IUS in the clinical outcomes measured. ClinicalTrials.gov:NCT00864136.

• Authors: Byung S Lee, Xu Ling, Shaheena Asif, Peter Kraemer, Jens U Hanisch, Pirjo Inki
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 121 Issue 1 Pg. 24-30 (Apr 2013) ISSN: 1879-3479 [Electronic] United States
• PMID: 23340271 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Antifibrinolytic Agents
• Contraceptive Agents, Female
• Contraceptives, Oral, Combined
• Progestins
• Levonorgestrel

Topics

• Adolescent
• Adult
• Antifibrinolytic Agents (therapeutic use)
• Asia
• Cohort Studies
• Contraceptive Agents, Female (administration & dosage, therapeutic use)
• Contraceptives, Oral, Combined (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Intrauterine Devices, Medicated
• Levonorgestrel (administration & dosage, therapeutic use)
• Menorrhagia (drug therapy)
• Middle Aged
• Progestins (therapeutic use)
• Prospective Studies
• Treatment Outcome
• Young Adult