Amsterdam Lisa L, Gentry William, Jobanputra Smeta, Wolf Michael, Rubin Stephen D, Bulun Serdar E
Indiana University School of Medicine, Indianapolis, Indiana, USA.
Fertil Steril. 2005 Aug;84(2):300-4. doi: 10.1016/j.fertnstert.2005.02.018.
To establish the use of aromatase inhibitors as a therapeutic option for endometriosis.
Prospective open-label Food and Drug Administration phase 2 trial with Institutional Review Board approval.
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 (Arimidex; AstraZeneca, Wilmington, DE) and one tablet of 20 microg ethinyl estradiol/0.1 mg levonorgestrel (Alesse; 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 function tests, 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 levels 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 microg ethinyl estradiol/0.1 mg levonorgestrel with minimal side effects. This treatment for endometriosis is a promising new modality that warrants further investigation.
确立芳香化酶抑制剂作为子宫内膜异位症的一种治疗选择。
经机构审查委员会批准的前瞻性开放标签食品药品监督管理局2期试验。
门诊三级护理中心。
15名有难治性子宫内膜异位症和慢性盆腔疼痛记录的绝经前患者。
在停用子宫内膜异位症激素疗法1个月后，女性每天服用1毫克阿那曲唑（瑞宁得；阿斯利康公司，特拉华州威尔明顿）和一片20微克炔雌醇/0.1毫克左炔诺孕酮（雅施达；惠氏公司，新泽西州麦迪逊），持续6个月。
模拟疼痛量表在基线时以及每个治疗月后通过每日日记和调查记录盆腔疼痛情况。监测副作用、血细胞计数、肝肾功能检查、胆固醇水平和骨密度。
15名患者中有14名疼痛显著减轻。6个月后疼痛中位数评分下降了55%，而平均疼痛评分下降了40%。将每个治疗月与基线相比，疼痛减轻具有统计学意义。平均疼痛评分仅在1个治疗月后就开始下降，并在随后的每个月持续降低。没有器官系统出现不良反应。治疗期间雌二醇水平受到抑制。副作用轻微且随时间改善。
15名难治性子宫内膜异位症患者中有14名使用阿那曲唑和20微克炔雌醇/0.1毫克左炔诺孕酮后疼痛得到显著缓解，且副作用极小。这种子宫内膜异位症治疗方法是一种有前景的新方式，值得进一步研究。
