Department of Obstetrics and Gynecology Helena Venizelou Hospital, Athens, Greece.
Department of Obstetrics and Gynecology.The Democritus University of Thrace, Alexandroupolis, Greece.
Drug Des Devel Ther. 2023 May 4;17:1329-1346. doi: 10.2147/DDDT.S315726. eCollection 2023.
Endometriosis is a chronic gynecologic condition that affects around 6-10% of reproductive age women. This clinical entity is characterized with pelvic pain, dysmenorrhea, dyspareunia, and infertility which are the most often presenting symptoms. Aromatase P450 is the key enzyme for ovarian estrogen biosynthesis and there is evidence that endometriotic lesions express aromatase and are able to synthesize their own estrogens. Aromatase inhibitors (AIs) are potent drugs that suppress the estrogen synthesis via suppression of aromatase. We performed a systematic review of systematic reviews and narrative reviews on the use of aromatase inhibitors in the medical management of endometriosis. We searched: PubMed (1950-2022), Google Scholar (2004-2022), Cochrane Library (2010-2022) and Researchgate (2010-2022). The search included the following medical subject headings (MeSH) or keywords: "Aromatase Inhibitors" AND "Endometriosis" AND "Systematic reviews" OR "Systematic review" AND "Reviews" OR "Reviews" AND "Endometriosis". The electronic database search yielded initially 12,106 studies from the different databases. Further assessment of the studies resulted in exclusion of (n = 12,015) studies due to duplicates and irrelevance; Finally, 24 studies were selected for inclusion, 5 were Systematic reviews and 19 were Narrative reviews. The 5 systematic reviews were assessed by AMSTAR-2 criteria and were found to have low quality. Narrative reviews were assessed with SANRA criteria and were found to have high-quality aromatase inhibitors are potent drugs that can manage the endometriosis-related symptoms in cases where initial medical management has failed to show positive results. However, their use is limited by the adverse effects that are linked with menopausal symptoms. aromatase inhibitors can be administered as an alternative treatment in patients. Future studies with randomized design are required to reach safer conclusions and further investigation. These studies should define the therapeutic dose, new add-back therapy modalities. Future directions should examine the most-appropriate way of administration and the duration of therapy.
子宫内膜异位症是一种常见的妇科疾病，影响约 6-10%的育龄妇女。这种临床实体的特征是盆腔疼痛、痛经、性交困难和不孕，这些是最常见的表现症状。芳香化酶 P450 是卵巢雌激素生物合成的关键酶，有证据表明子宫内膜异位症病变表达芳香化酶，能够合成自己的雌激素。芳香化酶抑制剂 (AIs) 是一种通过抑制芳香化酶来抑制雌激素合成的有效药物。我们对芳香化酶抑制剂在子宫内膜异位症的医学治疗中的应用进行了系统评价的系统评价和叙述性综述。我们搜索了：PubMed（1950-2022）、Google Scholar（2004-2022）、Cochrane Library（2010-2022）和 Researchgate（2010-2022）。搜索包括以下医学主题词（MeSH）或关键词："Aromatase Inhibitors" AND "Endometriosis" AND "Systematic reviews" OR "Systematic review" AND "Reviews" OR "Reviews" AND "Endometriosis"。来自不同数据库的电子数据库搜索最初产生了 12,106 项研究。进一步评估这些研究导致排除了（n=12,015）项研究，因为重复和不相关；最后，选择了 24 项研究进行纳入，其中 5 项是系统评价，19 项是叙述性综述。这 5 项系统评价根据 AMSTAR-2 标准进行评估，被认为质量较低。叙述性综述根据 SANRA 标准进行评估，被认为具有高质量。芳香化酶抑制剂是一种有效的药物，可以在初始药物治疗未能显示出积极效果的情况下，治疗与子宫内膜异位症相关的症状。然而，它们的使用受到与绝经症状相关的不良反应的限制。在药物治疗失败的情况下，可以将芳香化酶抑制剂作为替代治疗方法。需要进一步研究以达到更安全的结论和进一步的调查。这些研究应该确定治疗剂量、新的添加治疗模式。未来的研究方向应该研究最适当的给药方式和治疗持续时间。
