a Academic Unit of Obstetrics and Gynecology , Ospedale Policlinico San Martino , Genoa , Italy.
b Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) , University of Genoa , Genoa , Italy.
Expert Opin Biol Ther. 2019 Apr;19(4):343-360. doi: 10.1080/14712598.2019.1581761. Epub 2019 Feb 27.
Endometriosis is a chronic benign estrogen-dependent disease characterized by the presence of endometriotic glands and stroma outside the uterine cavity. Although combined hormonal contraceptives and progestins, currently available first-line treatments for endometriosis, are efficacious and well tolerated for treating disease-related pain, some women experience partial or no improvement of pain or its recurrence is frequent after discontinuation of the therapies. For these reasons, new drugs are under investigation for the treatment of endometriosis.
This review aims to give to the reader a complete and updated overview of hormonal and biological therapies for the treatment of endometriosis, underlining the latest developments in this field of research.
Among the new drugs investigated, late clinical trials on gonadotropin-releasing hormone (GnRH) antagonists and aromatase inhibitors (AIs) have demonstrated the most promising results. For this reason, elagolix, a new GnRH-antagonist, recently received the approval by the Food and Drug Administration (FDA) for treating pain associated to endometriosis. Other drugs with innovative targets have been identified, but the majority of these compounds have only been evaluated in pre-clinical studies or early clinical trials. Thus, a further extensive clinical research is necessary to better elucidate their pharmacologic characteristics, their efficacy, and safety for the treatment of this benign chronic disease.
子宫内膜异位症是一种慢性良性雌激素依赖性疾病，其特征是在子宫腔外存在子宫内膜腺体和基质。尽管联合激素避孕药和孕激素是目前治疗子宫内膜异位症的一线药物，对治疗与疾病相关的疼痛有效且耐受性良好，但一些女性的疼痛部分或完全没有改善，或在治疗停止后疼痛经常复发。出于这些原因，正在研究新的药物来治疗子宫内膜异位症。
本篇综述旨在为读者提供关于治疗子宫内膜异位症的激素和生物疗法的全面和最新概述，强调该研究领域的最新进展。
在研究的新药中，促性腺激素释放激素（GnRH）拮抗剂和芳香化酶抑制剂（AIs）的晚期临床试验显示出最有希望的结果。因此，一种新型 GnRH 拮抗剂——elagolix 最近获得了美国食品和药物管理局（FDA）的批准，用于治疗与子宫内膜异位症相关的疼痛。已经确定了其他具有创新靶点的药物，但这些化合物中的大多数仅在临床前研究或早期临床试验中进行了评估。因此，需要进一步进行广泛的临床研究，以更好地阐明它们在治疗这种良性慢性疾病方面的药理特性、疗效和安全性。
