Chao Peng1, Yan Huang1, Yingfang Zhou2. 1. Department of Obstetrics and Gynecology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, China. 2. Department of Obstetrics and Gynecology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, China. zhouyf8853@163.com.
Abstract
PURPOSE: Endometriosis is a common, chronic gynecological disease that affects women's fertility potential. Dydrogesterone is an effective and safe drug that is under-utilized due to limited clinical research. The purpose of this evidence mapping is to identify, describe, and analyze the current available evidence regarding dydrogesterone for the treatment of endometriosis. MATERIALS AND METHODS: We performed a search in electronic databases: Medline, The Cochrane Library, EMBASE, PubMed, CNKI, Wanfang, VIP, and CBM. We also hand-searched google for relevant studies. Our primary outcomes included changes in pain relief including pelvic pain, dysmenorrhea, and dyspareunia. Secondary outcomes included pregnancy rate, frequency of analgesic use, and other reported outcomes according to specific settings in the studies. RESULTS: Of 377 references screened, 19 studies were included in the data synthesis involving 1709 female participants. Nearly three-quarters were either randomized control trials or clinical control trials. Compared with gestrinone, dydrogesterone relieved dysmenorrhea, increased the pregnancy rate, and reduced the risk of certain adverse events. Compared with GnRH-a, dydrogesterone also lowered the risk of endometriosis recurrence and elevated transaminase levels. Whether there was any difference in efficacy between dydrogesterone and leuprolide acetate, letrozole or traditional Chinese medicine remains unclear due to insufficient data. CONCLUSIONS: The amount and quality of evidence evaluating the effects of dydrogesterone for the treatment of endometriosis is generally very low. Limited evidence suggests that dydrogesterone may have some advantages over gestrinone, GnRH agonists, and other therapeutic interventions in treating endometriosis. However, this conclusion should be interpreted with caution.
PURPOSE:Endometriosis is a common, chronic gynecological disease that affects women's fertility potential. Dydrogesterone is an effective and safe drug that is under-utilized due to limited clinical research. The purpose of this evidence mapping is to identify, describe, and analyze the current available evidence regarding dydrogesterone for the treatment of endometriosis. MATERIALS AND METHODS: We performed a search in electronic databases: Medline, The Cochrane Library, EMBASE, PubMed, CNKI, Wanfang, VIP, and CBM. We also hand-searched google for relevant studies. Our primary outcomes included changes in pain relief including pelvic pain, dysmenorrhea, and dyspareunia. Secondary outcomes included pregnancy rate, frequency of analgesic use, and other reported outcomes according to specific settings in the studies. RESULTS: Of 377 references screened, 19 studies were included in the data synthesis involving 1709 female participants. Nearly three-quarters were either randomized control trials or clinical control trials. Compared with gestrinone, dydrogesterone relieved dysmenorrhea, increased the pregnancy rate, and reduced the risk of certain adverse events. Compared with GnRH-a, dydrogesterone also lowered the risk of endometriosis recurrence and elevated transaminase levels. Whether there was any difference in efficacy between dydrogesterone and leuprolide acetate, letrozole or traditional Chinese medicine remains unclear due to insufficient data. CONCLUSIONS: The amount and quality of evidence evaluating the effects of dydrogesterone for the treatment of endometriosis is generally very low. Limited evidence suggests that dydrogesterone may have some advantages over gestrinone, GnRH agonists, and other therapeutic interventions in treating endometriosis. However, this conclusion should be interpreted with caution.
Authors: Valentina L La Rosa; Pasquale De Franciscis; Fabio Barra; Antonio Schiattarella; Alessandro Tropea; Jan Tesarik; Mohsin Shah; Ilker Kahramanoglu; Tais Marques Cerentini; Marco Ponta; Simone Ferrero Journal: Minerva Med Date: 2019-11-11 Impact factor: 4.806
Authors: Soo Hyun Ahn; Stephany P Monsanto; Caragh Miller; Sukhbir S Singh; Richard Thomas; Chandrakant Tayade Journal: Biomed Res Int Date: 2015-07-12 Impact factor: 3.411
Authors: Valentina L La Rosa; Pasquale De Franciscis; Fabio Barra; Antonio Schiattarella; Péter Török; Mohsin Shah; Erbil Karaman; Tais Marques Cerentini; Federica Di Guardo; Giuseppe Gullo; Marco Ponta; Simone Ferrero Journal: Minerva Med Date: 2019-11-12 Impact factor: 4.806