Document Detail


Gonadotropin-releasing hormone agonist plus estrogen-progestin "add-back" therapy for endometriosis-related pelvic pain.
MedLine Citation:
PMID:  8339817     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and efficacy of leuprolide acetate depot (LA, Lupron; TAP Pharmaceuticals, Deerfield, IL) plus daily conjugated equine estrogens (Es, Premarin; Wyeth-Ayerst Laboratories, Philadelphia, PA), and medroxyprogesterone acetate (MPA, Provera; The Upjohn Company, Kalamazoo, MI) "add-back" treatment of endometriosis-associated pelvic pain. DESIGN: Retrospective case series. SETTING: Tertiary care, academic medical center. PATIENTS: Eight patients with moderate to severe pelvic pain and laparoscopically documented endometriosis. INTERVENTION: Leuprolide acetate depot 3.75 mg IM every 4 weeks for 24 months. Oral conjugated equine Es 0.625 mg/d plus MPA 2.5 mg/d were also taken from treatment months 3 through 24. RESULTS: Six women completed the 2-year study. Mean revised endometriosis scores for implants, adhesions, and total values were significantly reduced at the conclusion of treatment from pretreatment scores. Self-reported pelvic pain scores were significantly lower at treatment months 3, 6, 12, 18, 24, and 6 months after therapy than pretreatment scores. Dual X-ray absorptiometry bone density measurements of the lumbar spine did not change significantly during the 24-month treatment period. The proportion of women experiencing hot flushes was significantly reduced after E-progestin add-back treatment from the proportion at treatment month 3. CONCLUSION: Treatment with LA depot plus conjugated equine Es and MPA for 2 years was a safe and effective therapy for women with endometriosis and pelvic pain in this small retrospective study.
Authors:
A J Friedman; M D Hornstein
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Retracted Publication    
Journal Detail:
Title:  Fertility and sterility     Volume:  60     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-09-02     Completed Date:  1993-09-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  236-41     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bone Density / drug effects
Drug Implants
Endometriosis / physiopathology*
Estrogens / administration & dosage*,  adverse effects,  therapeutic use
Female
Humans
Leuprolide / administration & dosage,  adverse effects,  therapeutic use*
Menstruation / drug effects
Pain / drug therapy*,  physiopathology
Pelvis*
Progestins / administration & dosage*,  adverse effects,  therapeutic use
Grant Support
ID/Acronym/Agency:
7-M01-RR02635-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Drug Implants; 0/Estrogens; 0/Progestins; 53714-56-0/Leuprolide
Comments/Corrections
Comment In:
NIH Guide Grants Contracts. 1996 May 10;25(15):2   [PMID:  8615994 ]
Fertil Steril. 1994 Feb;61(2):404-6   [PMID:  8299809 ]
Retraction In:
Friedman AJ. Fertil Steril. 1996 Jan;65(1):211   [PMID:  8557149 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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