Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis: a systematic review and meta-analysis,Archives of Gynecology and Obstetrics

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Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis: a systematic review and meta-analysis
Archives of Gynecology and Obstetrics ( IF 2.1 ) Pub Date : 2022-11-24 , DOI: 10.1007/s00404-022-06846-0
Luiz Paulo de Souza Pinto ₁ , Gustavo Ferrari _{2,

3,

4,

5} , Isis Kelly Dos Santos ₆ , Carlos Rodrigo de Mello Roesler ₃ , Izabelle de Mello Gindri _{2,

4}

Affiliation

Purpose

Endometriosis is a common chronic gynecological disease defined as the presence of endometrial glands and stroma tissue outside the uterus. Gestrinone is an effective antiestrogen that induces endometrial atrophy and/or amenorrhea. The purpose of this systematic review is to provide an evaluation of safety and effectiveness of gestrinone for the treatment of endometriosis.

Methods

We performed a search in six electronic databases: PubMed, MEDLINE (ovid), Embase, Cochrane CENTRAL (clinical trials), Web of Science and Scopus. Our selected primary outcomes were the changes in dysmenorrhea, pain relief including pelvic pain and dyspareunia. The secondary outcomes embrace hormones parameters, pregnancy rate and adverse events.

Results

Of 3269 references screened, 16 studies were included involving 1286 women. All studies compared gestrinone with other drugs treatments (placebo, Danazol, Mifepristone tablets, Leuprolide acetate, Quyu Jiedu Recipe) during 6 months. When compared with other drugs treatments, gestrinone relieved dysmenorrhea, pelvic pain, and morphologic response in the ovary. There was an increase on the pregnancy rate. Regarding the side effects observed, gestrinone showed the same adverse events and increased the risk of acne and seborrhea when compared to other treatments. Even if there was any difference in efficacy between gestrinone, danazol, leuprolide acetate, or Quyu Jiedu Recipe Chinese Medicine, it remains unclear due to insufficient data.

Conclusion

Based limited evidence available suggests that gestrinone appeared to be safe and may have some efficacy advantages over danazol, as well as other therapeutic interventions for treating endometriosis. However, this conclusion should be interpreted with caution, due the quality of the evidence provided is generally very low or unclear.

Trial registration

CRD42021284148.

中文翻译：

评价孕三烯酮治疗子宫内膜异位症的安全性和有效性：系统评价和荟萃分析

目的

子宫内膜异位症是一种常见的慢性妇科疾病，定义为子宫外存在子宫内膜腺体和间质组织。孕三烯酮是一种有效的抗雌激素，可诱导子宫内膜萎缩和/或闭经。本系统评价的目的是评估孕三烯酮治疗子宫内膜异位症的安全性和有效性。

方法

我们在六个电子数据库中进行了搜索：PubMed、MEDLINE (ovid)、Embase、Cochrane CENTRAL（临床试验）、Web of Science 和 Scopus。我们选择的主要结果是痛经的变化、疼痛缓解（包括盆腔疼痛和性交痛）。次要结果包括激素参数、妊娠率和不良事件。

结果

在筛选的 3269 份参考文献中，纳入了 16 项研究，涉及 1286 名女性。所有研究都比较了 6 个月内孕三烯酮与其他药物治疗（安慰剂、达那唑、米非司酮片、醋酸亮丙瑞林、祛瘀解毒方）。与其他药物治疗相比，孕三烯酮可缓解痛经、盆腔疼痛和卵巢形态学反应。怀孕率有所增加。关于观察到的副作用，与其他治疗方法相比，孕三烯酮显示出相同的不良事件并增加了痤疮和皮脂溢出的风险。纵使孕三烯酮、达那唑、醋酸亮丙瑞林或祛瘀解毒方中药疗效有差异，但因资料不足，尚无定论。