DEPOT LEUPROLIDE ACETATE VERSUS DANAZOL FOR TREATMENT OF PELVIC ENDOMETRIOSIS - CHANGES IN VERTEBRAL BONE MASS AND SERUM ESTRADIOL AND CALCITONIN
DEPOT LEUPROLIDE ACETATE VERSUS DANAZOL FOR TREATMENT OF PELVIC ENDOMETRIOSIS - CHANGES IN VERTEBRAL BONE MASS AND SERUM ESTRADIOL AND CALCITONIN
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DOI：
10.1016/s0015-0282(16)57593-1
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发表时间：
1995-06-01
影响因子：
6.7
通讯作者：
KHANDAWOOD, FS
中科院分区：
文献类型：
--
作者：
DAWOOD, MY;RAMOS, J;KHANDAWOOD, FS
Objective: To determine changes in trabecular vertebral bone mass, serum E-2, and serum calcitonin during and after therapy of pelvic endometriosis with depot leuprolide acetate (LA) or danazol.Design: Prospective, randomized, double-blind study.Setting: Academic university hospital and department of obstetrics and gynecology.Patients: Twelve women with symptomatic pelvic endometriosis diagnosed and staged by laparoscopy.Interventions: All patients received blinded treatment with either 3.75 mg IM depot LA given every month and daily placebo tablets (n = 6) or 800 mg oral danazol daily with a monthly placebo injection (n = 6) for 24 weeks.Main Outcome Measures: Quantitated computerized tomography of bone density of thoracic 12 to lumbar 4 vertebral bodies were determined before, at the end of 24 weeks of treatment, and 6 and 12 months after completing treatment. Gain or loss of bone mass was based against pretreatment levels. Serial serum levels of E-2 and calcitonin before, throughout, and after therapy were compared with changes in bone mass.Results: Bone loss with LA was 14.0% +/- 0.5% (mean +/- SEM), recovering to a deficit of 4.2% +/- 3.8% and 3.3%, 6 and 12 months after stopping therapy. Danazol increased bone by 5.4% +/- 2.2%, with a further gain to 8.2% +/-: 3.5% and 7.5%, 6 and 12 months after stopping treatment. Serum E-2 levels usually were 47.3 pg/mL with danazol. Calcitonin levels did not change significantly with either treatment.Conclusion: Depot LA produced marked sustained hypoestrogenemia and significant bone loss with incomplete recovery 1 year after stopping treatment. Danazol maintained normoestrogenemia and increased bone mass with the gain maintained even 1 year after stopping therapy.
