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Dienogest in the treatment of endometriosis: systematic review

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Abstract

Purpose

Endometriosis is a prevalent disease that affects 5–15 % of women of reproductive age. The aim of this study is to assess the effect of dienogest in the treatment of endometriosis.

Methods

The search was applied to electronic databases PubMed, Cochrane, EMBASE and Lilacs until September 2014, in a public tertiary hospital. We performed a systematic literature search of randomized trials comparing dienogest to other medical therapies in the treatment of endometriosis, as well as their references list, using the keywords “dienogest” and “endometriosis” by two independent authors. The data extraction were performed by two authors using predefined data fields. Nine randomized trials were included. Dienogest 2 mg/day was superior to placebo in reducing pelvic pain (27.4 versus 15.1 mm, P < 0.0001), with similar results to buserelin, leuprorelin, leuprolide acetate and triptorelin, in controlling symptoms associated with endometriosis. Dienogest 2 mg/day was effective in reducing endometriotic lesions (11.4 ± 1.71–3.6 ± 0.95, P < 0.001). The extended therapy with dienogest 2 mg/day also showed an improvement in pelvic pain after 24–52 weeks (−22.5 ± 32.1 and −28.4 ± 29.9 mm, respectively) with tolerable side effects.

Conclusion

Dienogest should be considered as an alternative for controlling symptoms related to endometriosis. Nevertheless, in this systematic review, no studies were found comparing dienogest with first-line therapy, such as progestins and estrogen–progestogen combinations, which are proved to be effective in the treatment of endometriosis, are less expensive, and also can be used for contraception.

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Authors and Affiliations

  1. Endometriosis Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, CEP, 05403-010, Brazil

    Marina de Paula Andres, Livia Alves Lopes & Sergio Podgaec

  2. Gynecologic Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil

    Edmund Chada Baracat

Authors
  1. Marina de Paula Andres
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  2. Livia Alves Lopes
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  3. Edmund Chada Baracat
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  4. Sergio Podgaec
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Correspondence to Marina de Paula Andres.

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Andres, M.d., Lopes, L.A., Baracat, E.C. et al. Dienogest in the treatment of endometriosis: systematic review. Arch Gynecol Obstet 292, 523–529 (2015). https://doi.org/10.1007/s00404-015-3681-6

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  • DOI: https://doi.org/10.1007/s00404-015-3681-6

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