Women's Health Institute, Cleveland Clinic Foundation , Cleveland, OH, United States.
Women's Health Institute, Division of Reproductive Endocrinology and Infertility, Cleveland Clinic Foundation , Cleveland, OH, United States.
Expert Opin Pharmacother. 2020 Jun;21(8):893-903. doi: 10.1080/14656566.2020.1738386. Epub 2020 Mar 12.
Endometriosis is estimated to affect 10% of reproductive-aged women. The gold standard for treatment is surgery; however, surgery carries a significant morbidity and cost burden. There is an ongoing need for safe, effective medical therapies for endometriosis patients, both in conjunction with and independent of surgical interventions. Most conventional therapies for endometriosis work by a similar mechanism, and efficacy is variable. In recent years, there has been increased interest in the development and testing of novel pharmacotherapies for endometriosis.
This review discusses both conventional and emerging treatments for endometriosis. The authors present the application of these drugs in different presentations of endometriosis across the lifespan and discuss how emerging therapies might fit into future medical management of endometriosis. Conventional therapies include nonsteroidal anti-inflammatory drugs, combined oral contraceptives, progestins, GnRH agonists/antagonists, and aromatase inhibitors. Emerging therapies are focused on disease-specific targets such as endothelial growth factor receptors.
The field of endometriosis therapy is moving toward modifying the immune and inflammatory milieu surrounding endometrial implants. If these drugs show efficacy in clinical trials, combining them with current medical treatment is expected to result in a profound impact on symptom and disease burden for patients who suffer from endometriosis worldwide.
子宫内膜异位症估计影响 10%的育龄妇女。治疗的金标准是手术；然而，手术有显著的发病率和成本负担。对于子宫内膜异位症患者，无论是与手术干预相结合还是独立于手术干预，都需要安全、有效的医学治疗方法。大多数子宫内膜异位症的常规治疗方法都通过类似的机制起作用，疗效各不相同。近年来，人们对开发和测试子宫内膜异位症的新型药物治疗方法越来越感兴趣。
这篇综述讨论了子宫内膜异位症的常规和新兴治疗方法。作者介绍了这些药物在不同年龄段和不同临床表现的子宫内膜异位症中的应用，并讨论了新兴疗法如何适应子宫内膜异位症未来的医学管理。常规治疗包括非甾体抗炎药、复方口服避孕药、孕激素、促性腺激素释放激素激动剂/拮抗剂和芳香化酶抑制剂。新兴疗法专注于疾病特异性靶点，如内皮生长因子受体。
子宫内膜异位症治疗领域正在朝着改变围绕子宫内膜植入物的免疫和炎症环境的方向发展。如果这些药物在临床试验中显示出疗效，预计将它们与当前的医学治疗相结合，将对全球患有子宫内膜异位症的患者的症状和疾病负担产生深远影响。
