Efficacy and safety endpoints of dienogest treatment of endometriosis: a systematic review

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Abstract

The synthetic progestogen dienogest has been closely studied in recent years for its therapeutic efficacy in endometriosis. Despite its benign nature, this disease is a serious problem due to its widespread prevalence and negative impact on various aspects of quality of life.

This systematic review analyzed the effectiveness of dienogest treatment using various scales and questionnaires to assess the dynamics of endometriosis symptoms (dysmenorrhea, chronic pelvic pain, deep dyspareunia), as well as intestinal and urological symptoms associated with endometriosis. The results of assessing the quality of life and patient satisfaction with dienogest treatment are presented. The endpoints for the efficacy of dienogest therapy included changes in laboratory (CA-125 and anti-Müllerian hormone levels) and instrumental (pelvic and mammary gland ultrasound, pelvic magnetic resonance imaging) examinations. We analyzed the effects of dienogest therapy as preoperative preparation to improve prognosis and postoperative treatment to prevent recurrence of the disease. To determine the safety profile, all adverse effects were recorded, including those related to the mammary glands. Bone mineral density, incidence of abnormal uterine bleeding, and incidence of treatment discontinuation due to adverse reactions were also assessed. Thus, the review covered the main efficacy and safety endpoints of dienogest therapy in women with different endometriosis phenotypes. Based on the results of this systematic analysis, it can be concluded that dienogest therapy for endometriosis is effective and safe. However, a personalized approach is required for selection of optimal therapy.

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About the authors

Maria I. Yarmolinskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; North-West State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605

MD, Dr. Sci. (Medicine), Professor, Professor of the Russian Academy of Sciences, Honored Scientist of the Russian Federation

Russian Federation, Saint Petersburg; Saint Petersburg

Elena N. Andreeva

I.I. Dedov National Medical Research Center of Endocrinology

Email: endogin@mail.ru
ORCID iD: 0000-0001-8425-0020
SPIN-code: 1239-2937

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Vitaly F. Bezhenar

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: bez-vitaliy@yandex.ru
ORCID iD: 0000-0002-7807-4929
SPIN-code: 8626-7555

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Alexander A. Popov

Moscow Regional Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky

Email: gyn_endoscopy@mail.ru
ORCID iD: 0000-0001-8734-1673
SPIN-code: 5452-6728

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Sofya A. Cherkashina

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: sonyach@list.ru
ORCID iD: 0009-0005-7208-3575
SPIN-code: 8196-6010

MD

Russian Federation, Saint Petersburg

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2. Appendix 1. General characteristics of the studies
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3. Fig. 1. Changes in GIQLI and EHP-30 scores in women with endometriosis during treatment with 2 mg dienogest once daily. Adapted from [18]. © Barra F. et al., 2020. Distributed under the CC-BY 4.0 license.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 66759 от 08.08.2016 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия Эл № 77 - 6389 от 15.07.2002 г.