( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .
Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study.
During the past decade , the development of various gonadotrophin-releasing hormone ( Gn-RH ) agonists , which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis . In an open , multicentre phase III study , the efficacy , tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested . The preliminary results of 104 women treated in seven German centres are presented . Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system : 33 % of patients had minimal , 22 % mild , 28 % moderate and 8 % severe endometriosis and in 9 % no pathological results were obtained . The patients ' mean age was 30 + /- 6 years and 66 had infertility problems . Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg , repeated once monthly over 24 weeks . A follow-up period of 12 months after the last injection has been completed in 70 patients , including a second laparoscopy . At all visits , symptoms were evaluated , physical examinations performed , and blood sample s collected for haematological screening , serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate . The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate . Of the total number of patients , 89 % had improvements in their endometriosis , 8 % a deterioration and 3 % no change . Patients reported improvement in the following : dysmenorrhoea 93 % , dyspareunia 62 % and pelvic pain 70 % . However , all women complained of at least one of the following symptoms : hot flushes 86 % , sleep disturbance 62 % , sweating 61 % , headache 41 % , nausea 32 % and depression 20 % . Fifty-five percent of patients reported additional side effects such as vaginal dryness , fatigue and lower abdominal pain . After the third injection , amenorrhoea persisted in 94 % of the women . Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml , follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period . During the 6 months ' treatment , laboratory parameters showed no significant deviations from normal ; only total cholesterol , high-density lipoprotein cholesterol and alkaline phosphatase increased . Treatment results were judged as good and satisfactory in 82 % and 11 % of cases , respectively . On the basis of this study , it can be concluded that leuprorelin acetate treatment is safe , well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints
( S ) Few studies of medical therapies for endometriosis report outcomes that are relevant to patients , and many women gain only limited or intermittent benefit from treatment
OBJECTIVE To assess patient response rates to medical therapies used to treat endometriosis-associated pain .