Treatment of Endometriosis with the GnRHa Deslorelin and Add-Back Estradiol and Supplementary Testosterone

• Published in: BioMed research international Vol. 2015; no. 2015; pp. 1 - 9
• Main Authors: Daniels, John R., Pike, Malcolm C., Foster, W. G., Udoff, Laurence, Drosman, Steven R., Daniels, AnnaMarie, Agarwal, S. K., Spicer, Darcy V.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01-01-2015; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Adult; Biomedical research; Bone density; Bones; Care and treatment; Colleges & universities; Density; Dosage and administration; Drug dosages; Endometriosis; Endometriosis - drug therapy; Endometriosis - epidemiology; Enzyme Inhibitors - administration & dosage; Enzyme Inhibitors - therapeutic use; Estradiol; Estradiol - administration & dosage; Estradiol - therapeutic use; Estrogens; Female; Hormone replacement therapy; Humans; Menopause; Middle Aged; Pain; Pharmaceuticals; Phenols; Pituitary hormones; Preventive medicine; Quality of life; Sexual disorders; Testosterone; Testosterone - administration & dosage; Testosterone - therapeutic use; Transdermal medication; Triptorelin Pamoate - administration & dosage; Triptorelin Pamoate - analogs & derivatives; Triptorelin Pamoate - therapeutic use; Los Angeles California; United States > US
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2015/934164

Background. This randomized, multicenter, open-label clinical trial was intended to generate pilot data on the efficacy and safety of the gonadotropin-releasing hormone agonist (GnRHa) deslorelin (D) with low-dose estradiol ± testosterone (E2 ± T) add-back for endometriosis-related pelvic pain. Methods. Women with pelvic pain and laparoscopically confirmed endometriosis were treated with a six-month course of daily intranasal D with concurrent administration of either transdermal E2, intranasal E2, or intranasal E2 + T. Efficacy data included evaluation of dyspareunia, dysmenorrhea, pelvic pain, tenderness, and induration. Cognition and quality of life were also assessed. Safety parameters included assessment of endometrial hyperplasia, bone mineral density (BMD), and hot flashes. Results. Endometriosis symptoms and signs scores decreased in all treatment arms from a baseline average of 7.4 to 2.5 after 3 months of treatment and 3.4 after 6 months. BMD changes and incidence of hot flashes were minimal, and no endometrial hyperplasia was observed. Patient-reported outcomes showed significant improvement across multiple domains. Conclusions. Daily intranasal D with low dose E2 ± T add-back resulted in significant reduction in severity of endometriosis symptoms and signs with few safety signals and minimal hypoestrogenic symptoms that would be expected with the use of a GnRHa alone.