Schindler A E, Bühler K, Gerhard I, Wiedemann R, Kimmig R, Schüssler B, Kranzfelder D, Mall-Häfeli M, Meinen K, Mancarella D
Universitätsfrauenklinik Essen.
Zentralbl Gynakol. 1994;116(12):679-86.
In an open, non-randomized prospective phase-III-study the clinical and endocrine efficacy as well as the safety of leuprorelin acetate depot (Enantone-Gyn Monats-Depot) were investigated. The therapeutic results of 198 patients, gathered from 5 university institutions and two city hospitals, are reported. Endometriosis was classified by the revised American Fertility Society score (r-AFS) before and at the end of treatment. Serum levels of LH, FSH, prolactin, estradiol, progesterone, androstenedione, testosterone and leuprorelin acetate were determined by radioimmunoassay. The mean total r-AFS score changed as follows: before surgical intervention during first-look laparoscopy 21 +/- 24 at the end of first-look laparoscopy 15 +/- 19 at the end of the GnRH-treatment 8 +/- 14 During leuprorelin acetate treatment the r-AFS stages changed as follows: [table; see text] Using the scoring system 85.2% of the patients improved. Relief of dysmenorrhoea could be achieved in 95.4%, relief of dyspareunia in 64% and of pelvic pain in 69.4% of patients. Baseline hormone levels dropped sharply during treatment. [table; see text] Androstenedione, testosterone, blood pressure, body weight, haematological parameters, liver enzymes, creatinine, electrolytes and HDL-/LDL-cholesterin remained more or less unchanged. Side effects being hot flushes, sweating, sleeplessness, headache, nausea, depression and vaginal dryness were due to estradiol deprivation. In 135 patients resumption of menstruation occurred in 95.6% within the first three months post-treatment. 23 patients of whom 21 were judged as infertile, became pregnant immediately after treatment was finished. The study results confirm the efficacy of leuprorelin acetate depot in the treatment of even advanced stages of endometriosis.
在一项开放性、非随机前瞻性III期研究中,对醋酸亮丙瑞林长效注射剂(Enantone - Gyn Monats - Depot)的临床和内分泌疗效以及安全性进行了研究。报告了来自5所大学机构和两家城市医院的198例患者的治疗结果。在治疗前和治疗结束时,根据修订的美国生育协会评分(r - AFS)对子宫内膜异位症进行分类。通过放射免疫分析法测定血清促黄体生成素(LH)、促卵泡生成素(FSH)、催乳素、雌二醇、孕酮、雄烯二酮、睾酮和醋酸亮丙瑞林的水平。r - AFS总分均值变化如下:手术干预前为21±24,初次腹腔镜检查时为15±19,促性腺激素释放激素(GnRH)治疗结束时为8±14。在醋酸亮丙瑞林治疗期间,r - AFS分期变化如下:[表格;见正文] 使用评分系统,85.2%的患者病情改善。95.4%的患者痛经得到缓解,64%的患者性交困难得到缓解,69.4%的患者盆腔疼痛得到缓解。治疗期间基线激素水平急剧下降。[表格;见正文] 雄烯二酮、睾酮、血压、体重、血液学参数、肝酶、肌酐、电解质和高密度脂蛋白/低密度脂蛋白胆固醇水平或多或少保持不变。潮热、出汗、失眠、头痛、恶心、抑郁和阴道干燥等副作用是由于雌激素缺乏所致。135例患者中,95.6%在治疗后前三个月内月经恢复。23例患者(其中21例被判定为不孕)在治疗结束后立即怀孕。研究结果证实了醋酸亮丙瑞林长效注射剂在治疗甚至晚期子宫内膜异位症方面的疗效