Drug treatment for endometriosis-related pain


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Endometriosis remains one of the most pressing problems in gynecology. Despite a large number of studies, there is no ideal pathogenetically substantiated therapy for endometriosis today. Hormone therapy remains a mainstay of medical treatment for the disease. Despite that there are no indications for the treatment of endometriosis and pelvic pain, combined oral contraceptives (COCs) are commonly prescribed as before. However, due to data on the progression of the disease to a more invasive type in women who have taken COCs for primary dysmenorrhea, foreign and Russian guidelines are increasingly giving preference to gestagens in the treatment of endometriosis with pain syndrome, and, in case of their resistance, gonadotropin-releasing hormone agonists are chosen. Among the gestagens, dyirogesterone occupies a special place due to its high selectivity and good safety profile, which makes it currently the drug of choice in the treatment of endometriosis.

Full Text

Restricted Access

About the authors

Svetlana O. Dubrovina

Rostov State Medical University

Email: s.dubrovina@gmail.com
MD, professor, chief researcher, Rostov Scientific Research Institute of Obstetrics and Pediatrics

Yuliya D. Berlim

Rostov State Medical University

Email: juliaberlim@yandex.ru
PhD, head of the advisory outpatient department

References

  1. Santali Р., Tran С., Gayet V., Bourdon M., Maignien C., Marcellin L. et al. Oligo-anovulation is not a rarer feature in women with documented endometriosis. Fertil. Steril. 2018; 110(5): 941-8.
  2. Saridogan E. Adolescent endometriosis. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017; 209: 46-9.
  3. De Sanctis V., Matalliotakis M., Soliman A., Elsefdy H., Di Maio S., Fiscina B. A focus on the distinctions and current evidence of endometriosis in adolescents. Best Pract. Res. Clin. Obstet. Gynaecol. 2018; 15: 138-50.
  4. Moggio A., Pittatore G., Cassoni P., Marchino G.L., Revelli A., Bussolati B. Sorafenib inhibits growth, migration, and angiogenic potential of ectopic endometrial mesenchymal stem cells derived from patients with endometriosis. Fertil. Steril. 2012; 98(6): 1521-30.
  5. Albertsen H.M., Ward K. Genes linked to endometriosis by GWAS are integral to cytoskeleton regulation and suggests that mesothelial barrier homeostasis is a factor in the pathogenesis of endometriosis. Reprod. Sci. 2016; Jul 28. pii: 1933719116660847.
  6. Vercellini P., Buggio L., Frattaruolo M.P., Borghi A., Dridi D., Somigliana E. Medical treatment of endometriosis-related pain. Best Pract. Res. Clin. Obstet. Gynaecol. 2018; 51: 68-91. doi: 10.1016/j.bpobgyn.2018.01.015.
  7. Santulli P., Marcellin L., Menard S., Thubert T., Khoshnood B., Gayet V. et al. Increased rate of spontaneous miscarriages in endometriosis-affected women. Hum. Reprod. 2016; 31(5): 1014-23.
  8. Jensen J., Schlaff W., Gordon К. Use of combined hormonal contraceptives for the treatment of endometriosis-related pain: a systematic review of the evidence. Fertil. Steril. 2018; 110(1): 137-52. e1.
  9. Harada T., Kosaka S., Elliesen J., Yasuda M., Ito M., Momoeda M. Ethinylestradiol 20 mg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial. Fertil. Steril. 2017; 108(5): 798-805.
  10. Vercellini P., Somigliana E., Vigano P., Abbiati A., Barbara G., Fedele L. “Blood on the tracks’’ from corpora lutea to endometriomas. BJOG. 2009; 116(3): 366. e71.
  11. National Institute for Health and Care Excellence. Endometriosis: diagnosis and management. NICE guideline NG73. September, 2017. Available at: https://www.nice.org.uk/guidance/ng73/evidence/full-guideline-pdf-4550371315 Accessed 3 November, 2017
  12. Flores V.A., Vanhie A., Dang T., Taylor H.S. Progesterone receptor status as a predictor of response to progestins in endometriosis. Fertil. Steril. 2018; 110(4, Suppl.): e383.
  13. Vercellini Р., Ottolinia F., Frattaruolo М.Р., Buggio L., Roberto А., Somigliana Е. Shifting from oral contraceptives to norethisterone acetate, or vice versa, because of drug intolerance: does the change benefit women with endometriosis? Gynecol. Obstet. Invest. 2018; 83(3): 275-84. doi: 10.1159/000486335
  14. Miller J., Missmer S., Vitonis А., Sarda V., Laufer M., Di Vasta А. Prevalence of migraines in adolescents with endometriosis. Fertil. Steril. 2018; 109(4): 685-90.
  15. Chapron C., Souza C., Borghese B., Lafay-Pillet M.C., Santulli P., Bijaoui G. et al. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum. Reprod. 2011; 26(8): 2028-35.
  16. Casper R.F. Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills. Fertil. Steril. 2017; 107(3): 533-6.
  17. Дубровина С.О., Берлим Ю.Д. Гестагены в терапии эндометриоза. Акушерство и гинекология. 2018; 5: 150-5.
  18. Министерство Здравоохранения Российской Федерации. Клинические рекомендации. Эндометриоз. М.; 2016. ID: КР259.
  19. Приказ Минздрава России от 01.11.2012 N. 572н (ред. от 12.01.2016) «Об утверждении Порядка оказания медицинской помощи по профилю «акушерство и гинекология (за исключением использования вспомогательных репродуктивных технологий)» (Зарегистрировано в Минюсте России 02.04.2013 N. 27960).
  20. Vercellini P., Pietropaolo G., De Giorgi O., Pasin R., Chiodini A., Crosignani P.G. Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. Fertil. Steril. 2005; 84(5): 1375-87.
  21. Chwalisz K., Surrey E., Stanczyk F.Z. The hormonal profile of norethind-roneacetate: rationale for add-back therapy with gonadotropin-releasing hormone agonists in women with endometriosis. Reprod. Sci. 2012; 19(6): 563-71.
  22. Schindler A.E., Campagnoli C., Druckmann R., Huber J., Pasqualini J.R., Schweppe K.W., Thijssen J.H. Classification and pharmacology of progestins. Maturitas. 2008; 61(1-2): 171-80.
  23. Africander D., Verhoog N., Hapgood J.P. Molecular mechanisms of steroid receptor-mediated actions by synthetic progestins used in HRT and contraception. Steroids. 2011; 76(7): 636-52.
  24. Ebert A.D., Dong L., Merz M., Kirsch B., Francuski M., Bottcher B. et al. Dienogest 2 mg daily in the treatment of adolescents with clinically suspected endometriosis: the VISanne study to assess safety in adolescents. J. Pediatr. Adolesc. Gynecol. 2017; 30(5): 560. e7.
  25. Momoeda M., Harada T., Terakawa N., Aso T., Fukunaga M., Hagino H., Taketani Y. Long-term use of dienogest for the treatment of endometriosis. J. Obstet. Gynaecol. Res. 2009; 35(6): 1069-76.
  26. Petraglia F., Hornung D., Seitz C., Faustmann T., Gerlinger C., Luisi S. et al. Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment. Arch. Gynecol. Obstet. 2012; 285(1): 167-73.
  27. Kim S.A., Um M.J., Kim H.K., Kim S.J., Moon S.J., Jung H. Study of dieno-gest for dysmenorrhea and pelvic pain associated with endometriosis. Obstet. Gynecol. Sci. 2016; 59(6): 506-11.
  28. Jeonga S.H., Lee D., Kim S.K., Jee B.C. Symptom-alleviating effect and adverse effect of dienogest in Korean women with endometriosis. Gynecol. Endocrinol. 2018; 34(11): 970-4.
  29. Kohler G., Faustmann T.A., Gerlinger C., Seitz C., Mueck A.O. A dose-ranging study to determine the efficacy and safety of 1, 2, and 4mg of dienogest daily for endometriosis. Int. J. Gynaecol. Obstet. 2010; 108: 21-5.
  30. Strowitzki T., Marr J., Gerlinger C., Faustmann T., Seitz C. Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum. Reprod. 2010; 25(3): 633-41.
  31. Kitawaki J., Ishihara H., Kiyomizu M., Honjo H. Maintenance therapy involving a tapering dose of danazol or mid/low doses of oral contraceptive after gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain. Fertil. Steril. 2008; 89(6): 1831-5.
  32. Kitawaki J., Kusuki I., Yamanaka K., Suganuma I. Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain. Eur. J. Obstet. Gynecol. Reprod. Biol. 2011; 157: 212-6.
  33. Somigliana E., Vercellini P., Vigano P., Benaglia L., Busnelli A., Fedele L. Postoperative medical therapy after surgical treatment of endometriosis: from adjuvant therapy to tertiary prevention. J. Minim. Invasive Gynecol. 2014; 21(3): 328. e34.
  34. Di Francesco A., Pizzigallo D. Use of micronized palmitoylethanolamide and transpolydatin in chronic pelvic pain associated with endometriosis. An open-label study. Giorn. Ital. Ostetr. Ginecol. 2014; 36: 353-8.
  35. Vercellini P., de Giorgi O., Mosconi P., Stellato G., Vicentini S., Crosignani P.G. Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil. Steril. 2002; 77: 52-61.
  36. Zupi E., Marconi D., Sbracia M., Zullo F., de Vivo B., Exacustos C. et al. Add-back therapy in the treatment of endometriosis-associated pain. Fertil. Steril. 2004; 82(5): 1303-8.
  37. Liang B., Wu L., Xu H., Cheung C.W., Fung W.Y., Wong S.W., Wang C.C. Efficacy, safety and recurrence of new progestins and selective progesterone receptor modulator for the treatment of endometriosis: a comparison study in mice. Reprod. Biol. Endocrinol. 2018; 16(1): 32. DOI: 10.1186/ s12958-018-0347-9
  38. Дубровина С.О., Берлим Ю.Д., Арешан К.А., Гаджибекова Н.Б. Сравнительная характеристика эутопического и эктопического эндометрия при эндометриоидных кистах яичников с нормальным эндометрием. Проблемы репродукции. 2018; 24(6): 108-12. doi: 10.17116/repro201824061108.
  39. Mönckedieck V., Sannecke C., Husen B., Kumbartski M., Kimmig R., Tötsch M. et al. Progestins inhibit expression of MMPs and of angiogenic factors in human ectopic endometrial lesions in a mouse model. Mol. Hum. Reprod. 2009; 15(10): 633-43. doi: 10.1093/molehr/gap063.
  40. Bulun S.E., Cheng Y.H., Pavone M.E., Yin P., Imir G., Utsunomiya H. et al. 17b-Hydroxysteroid dehydrogenase-2 deficiency and progesterone resistance in endometriosis. Semin. Reprod. Med. 2010; 28: 44-50.
  41. Vercellini P., Buggio L., Berlanda N., Barbara G., Somigliana E., Bosari S. Estrogen-progestins and progestins for the management of endometriosis. Fertil. Steril. 2016; 106(7): 15520-71.
  42. Подзолкова Н.М., Татарчук Т.Ф., Дощанова А.М., Ешимбетова Г.З., Сумятина Л.В. Нормализация менструального цикла дидрогестероном. Акушерство и гинекология. 2018; 6: 70.
  43. Сухих Г.Т., Адамян Л.В., Серов В.Н., Андреева Е.Н., Баранов И.И., Дубровина С.О., Козаченко А.В., Кулешов В.М., Подзолкова Н.М., Прилепская В.Н., Радзинский В.Е., Сонова М.М., Тихомиров А.Л., Уварова Е.,В., Чернуха Г.Е., Ших Е.В., Ярмолинская М.И. Резолюция совещания экспертов на тему «Возможности персонализации гормональной терапии эндометриоза с использованием препарата дидрогестерон. Утверждение протокола многоцентрового открытого наблюдательного исследования по применению дидрогестерона для лечения эндометриоза в России (исследование «ОРХИДЕЯ»)». Проблемы репродукции. 2018; 24(5): 41-4. https://doi.org/10.17116/ repro20182405141.
  44. Государственный реестр лекарственных средств. Инструкция по медицинскому применению препарата Дюфастон от 26.07.2017. [The state register of medicines. Instructions for medical use of the drug Duphaston from 07.26.2017. (in Russian)]. Available at: https://grls.rosminzdrav.ru/ Grls_View_v2.aspx?routingGuid=3ee36e24-2022-40d7-9f6c-7d699a196f50&t Accessed 01.02.2019.
  45. Тетруашвили Н.К., Агаджанова А.А. Дидрогестерон в лечении угрожающего и привычного выкидыша. Медицинский совет. 2018; 13: 34-8.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies