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评价地诺孕素治疗伴有子宫内膜异位症的慢性周期性盆腔痛的长期疗效和安全性。

Evaluation of long-term efficacy and safety of dienogest in patients with chronic cyclic pelvic pain associated with endometriosis.

机构信息

HCU Obstetrics and Gynecology, ARNAS Civico Di Cristina-Benfratelli Hospital, Palermo, Italy.

Department of Medicine, University Kore of Enna, Enna, Italy.

出版信息

Arch Gynecol Obstet. 2024 Feb;309(2):589-597. doi: 10.1007/s00404-023-07271-7. Epub 2023 Nov 29.

Abstract

PURPOSE

To evaluate the efficacy and long-term safety (up to 108 months) of treatment with Dienogest in patients with endometriosis.

METHODS

Patients with chronic pelvic pain endometriosis-related were enrolled in this observational study from June 2012 to July 2021. The patients enrolled took Dienogest 2 mg as a single daily administration. Group B of long-term therapy patients (over 15 months) were compared with group A of short-term therapy patients (0-15 months). The effects of the drug on pain variation were assessed using the VAS scale and endometriomas dimensions through ultrasonographic evaluation. Furthermore, has been valuated the appearance of side effects and the effect of the drug on bone metabolism by performing MOC every 24 months in group B.

RESULTS

157 patients were enrolled. The mean size of the major endometrioma progressively decreased from 33.2 mm (29.4-36.9) at T0 to 7 mm (0-15.8) after 108 months of treatment. We found a significant improvement in dysmenorrhea, dyspareunia, dyschezia and non-cyclic pelvic pain. As for the side effects, both groups complained menstrual alterations present in 22.9%. In 27.6% of group B, osteopenia was found. Group B had a higher percentage statistically significant of side effects such as headaches, weight gain and libido reduction compared to group A. 2 CONCLUSION: Long-term therapy with Dienogest has proven effective in controlling the symptoms of the disease and reducing the size of endometriomas, with an increase in the positive effects related to the duration of the intake and in the absence of serious adverse events. Study approved by the "Palermo 2" Ethics Committee on July 2, 2012 No. 16.

摘要

目的

评估地诺孕素治疗子宫内膜异位症的疗效和长期安全性(长达 108 个月)。

方法

本观察性研究于 2012 年 6 月至 2021 年 7 月期间纳入慢性盆腔疼痛的子宫内膜异位症相关患者。纳入的患者每天服用地诺孕素 2 毫克。长期治疗组(超过 15 个月)的患者与短期治疗组(0-15 个月)的患者进行比较。使用 VAS 量表评估药物对疼痛变化的影响,通过超声评估评估内异症囊肿的尺寸。此外,通过每隔 24 个月对 B 组进行 MOC 评估,评估药物对骨代谢的影响。

结果

共纳入 157 例患者。主要内异症囊肿的平均大小从 T0 时的 33.2 毫米(29.4-36.9)逐渐减少至治疗 108 个月后的 7 毫米(0-15.8)。我们发现痛经、性交痛、排便困难和非周期性盆腔疼痛均有显著改善。至于副作用,两组均有 22.9%的患者出现月经改变。B 组中有 27.6%的患者发现骨质疏松症。与 A 组相比,B 组有更多的患者出现头痛、体重增加和性欲降低等副作用,其发生率具有统计学意义。

结论

地诺孕素的长期治疗已被证明能有效控制疾病症状和缩小内异症囊肿的大小,且随着摄入时间的延长,疗效增加,且无严重不良事件。本研究于 2012 年 7 月 2 日获得“巴勒莫 2 号”伦理委员会批准,编号为 16。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2fb/10808538/b73a168cba35/404_2023_7271_Fig1_HTML.jpg

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