Drug therapy for adenomyosis: a prospective, nonrandomized, parallel-controlled study.

Area of Science:

• Gynecology
• Reproductive Medicine
• Clinical Pharmacology

Background:

• Adenomyosis is a challenging gynecological condition impacting women's reproductive health.
• Current treatments for adenomyosis have limitations, necessitating exploration of alternative therapeutic strategies.
• Understanding the comparative efficacy and safety of different treatment regimens is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the clinical effectiveness and safety of varying doses of leuprorelin acetate (LA) and Mirena implantation for adenomyosis treatment.
• To compare the outcomes of LA monotherapy, Mirena monotherapy, and combination therapies.
• To identify optimal treatment strategies for adenomyosis, considering patient factors and treatment costs.

Main Methods:

• A prospective, nonrandomized, parallel-controlled study involving 200 patients with adenomyosis.
• Patients were assigned to six groups receiving different treatments: varying doses of leuprorelin acetate (LA), Mirena implantation, or combination therapies.
• Evaluated outcomes included uterine volume, pain scores, cancer antigen 125 levels, ovarian function, adverse effects, and Mirena expulsion over a 1-year follow-up.

Main Results:

• Lower dose (1.88 mg) LA resulted in reduced uterine volume and pain with significantly fewer hot flashes and sweating compared to higher dose (3.75 mg) LA.
• Combination therapy of LA with Mirena demonstrated lower Mirena expulsion rates (3.33%) compared to Mirena alone (10.00%).
• Combination therapy showed enhanced therapeutic effects, and lower dose LA regimens were associated with reduced costs.

Conclusions:

• 1.88 mg leuprorelin acetate (LA) presents a viable alternative treatment for adenomyosis, particularly in Asian populations, offering a favorable side effect profile.
• Combining leuprorelin acetate (LA) with Mirena implantation enhances therapeutic efficacy and reduces the risk of Mirena expulsion.
• The study provides valuable insights into optimizing adenomyosis management through tailored pharmacological and device-based interventions.