The effectiveness of the administration regimen of Buserelin-depo with a prolonged interval between injections: hormonal profile and acceptability of treatment for patients with endometriosis

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Abstract

Since gonadotropin releasing hormone (GnRH) agonists significantly suppress steroidogenesis, they contribute to the regression of endometrioid lesions and the decrease in clinical symptoms of the disease. However, hypoestrogenism caused by the prolonged use of GnRH agonists is complicated by the appearance of side effects. It is important to find the ways to reduce side effects while maintaining the effectiveness of GnRH agonists.

Objective: To assess the clinical and hormonal status of patients with extragenital endometriosis after taking 3.75 mg of Buserelin-depo with 6-week and 4-week intervals between the administration of the drug in the postoperative period.

Materials and methods: The patients of group I (n=10) were administered Buserelin-depo at a standard dose of 3.75 mg with an interval of 6 weeks; the patients of group II (n=10) who had ASRM stage I and II verified endometriosis were administered the drug according to the usual scheme with a 4-week interval. The study included the comparison of the dynamics of estradiol, LH, FSH, the rate of appearance and the profile of side effects associated with induced hypoestrogenism, the clinical efficacy of drug administration in both groups.

Results: The levels of FSH, LH and E2 in patients of both groups showed similar results of hormonal suppression. A decrease in pain syndrome was also observed after the administration of Buserelin-depo: 3.3 scores using the VAS system in group I and 2.4 scores in group II (compared to 9.9 points initially). Menstruation started again in 78 days after the fourth injection in group I and in 82 days after the sixth injection in group II. In both groups, adverse events were noted which were mild according to the Kupperman index (in 6/10 in group I, in 10/10 in group II). Neither endometrial growth nor signs of folliculogenesis were observed in any case in groups I and II.

Conclusion: The effectiveness of the administration of Buserelin-depo with an increased interval between injections for up to 6 weeks is equal to the effectiveness of its administration in the standard mode (every 4 weeks). However, the side effects were less severe. It is necessary to conduct a comprehensive study in order to clarify the effectiveness of the prolonged interval between injections using statistical analysis.

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About the authors

Nikolai N. Rukhliada

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Author for correspondence.
Email: nickolasr@mail.ru
ORCID iD: 0000-0002-3548-0468

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Mean FSH levels during and after treatment with 4- and 6-week intervals of Buserelin-depo administration

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3. Fig. 2. Mean LH levels during and after treatment with 4- and 6-week intervals of Buserelin-depo administration

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4. Fig. 3. Mean 17-β-estradiol levels during and after treatment with 4- and 6-week intervals of Buserelin-depo administration

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