Anastrazole and oral contraceptives: a novel treatment for endometriosis
Anastrazole and oral contraceptives: a novel treatment for endometriosis
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DOI：
10.1016/j.fertnstert.2005.02.018
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发表时间：
2005-08-01
影响因子：
6.7
通讯作者：
Bulun, SE
中科院分区：
文献类型：
--
作者：
Amsterdam, LL;Gentry, W;Bulun, SE
目的：目的：建立芳香化酶抑制剂作为子宫内膜异位症治疗选择的方法。设计：经机构审查委员会批准的前瞻性开放标签食品和药物管理局2期试验。设置：三级门诊护理中心。患者：15名绝经前患者，记录有难治性子宫内膜异位症和慢性盆腔疼痛。干预措施：子宫内膜异位症激素治疗1个月后，妇女服用1毫克阿那曲唑（Arimedex; AstraZeneca，威尔明顿，DE）和一片20 μ g炔雌醇/0.1 mg左炔诺孕酮（Aless; Wyeth，麦迪逊，NJ），持续6个月。主要结果测量：模拟疼痛量表在基线和每个治疗月后的每日日记和调查中记录骨盆疼痛。副作用，血细胞计数，肝和肾功能，胆固醇水平和骨密度进行了monitored. Results（s）：15例患者中有14例取得了显着的疼痛减轻。6个月后，中位疼痛评分下降55%，而平均疼痛评分下降40%。与基线相比，每个治疗月的疼痛减轻具有统计学显著性。平均疼痛评分仅在治疗1个月后开始下降，并在每个月继续下降。没有器官系统出现不良反应。在治疗期间抑制了雌二醇水平。副作用是轻微的，并随着时间的推移而改善。结论：15例顽固性子宫内膜异位症患者中有14例使用阿那曲唑和20 μ g炔雌醇/0.1 mg左炔诺孕酮实现了显着的疼痛缓解，副作用最小。这种治疗子宫内膜异位症是一种有前途的新模式，值得进一步研究。
Objective: To establish the use of aromatase inhibitors as a therapeutic option for endometriosis.Design: Prospective open-label Food and Drug Administration phase 2 trial with Institutional Review Board approval.Setting: Outpatient tertiary care centers.Patient(s): Fifteen premenopausal patients with documented refractory endometriosis and chronic pelvic pain.Intervention(s): After a 1-month washout of endometriosis hormone therapies, women took 1 mg anastrazole (Arimedex; AstraZeneca, Wilmington, DE) and one tablet of 20 mu g ethinyl astradiol/0.1 mg levonorgestrel (Aless; Wyeth, Madison, NJ) daily for 6 months.Main Outcome Measure(s): An analog pain scale recorded pelvic pain in daily diaries and surveys at baseline and after each treatment month. Side effects, blood counts, liver and renal functions, cholesterol levels, and bone density were monitored.Result(s): Fourteen of 15 patients achieved significant pain reduction. Median pain scores decreased 55% after 6 months, while mean pain scores decreased 40%. Pain reduction comparing each treatment month to baseline achieved statistical significance. Average pain scores began dropping after only 1 treatment month and continued decreasing each additional month. No organ system experienced adverse effects. Estradiol level were suppressed during treatment. Side effects were mild and improved over time.Conclusion(s): Fourteen of 15 patients with refractory endometriosis achieved significant pain relief using anastrazole and 20 mu g ethinyl estradiol/0.1 mg levonorgestrel with minimal side effects. This treatments for endometriosis is a promising new modality that warrants further investigation.