Exploring New Treatment Strategies for Endometriosis-Narrative Review
Katarzyna Błaszczak-Świątkiewicz1, Michael Oettel2
1Department of Pharmacology and Toxicology, Social Academy of Sciences, Sienkiewicza 9, 90-113 Łódź, Poland.
International Journal of Molecular Sciences
|August 13, 2026
Summary
Selective progesterone receptor modulators (SPRMs) show promise for endometriosis treatment but face development challenges. New mesoprogestins like EC313 demonstrate potential for improved efficacy and warrant further investigation in gynecological disorders.
Area of Science:
- Pharmacology
- Gynecology
- Endocrinology
Background:
- Selective progesterone receptor modulators (SPRMs) are investigated for endometriosis treatment.
- Dienogest (DNG), a pure progesterone receptor (PR) agonist, is a clinical standard.
- Previous SPRMs like Vilaprisan and Asoprisnil faced development hurdles due to safety and efficacy concerns.
Purpose of the Study:
- To compare the pharmacodynamic profiles of dienogest, vilaprisan, and asoprisnil in endometriosis treatment.
- To evaluate the potential of novel mesoprogestins, such as EC313, for improved endometriosis therapy.
- To explore strategies for enhancing drug discovery in the SPRM class for gynecological disorders.
Main Methods:
- Preclinical in vitro and in vivo studies.
- Review of clinical trial data for dienogest, vilaprisan, and asoprisnil.
- Preclinical evaluation of the novel mesoprogestin EC313.
Main Results:
- Vilaprisan development halted due to toxicology; Asoprisnil development discontinued due to endometrial changes.
- Ulipristal acetate linked to rare liver injury.
- EC313 shows higher PR agonistic/antagonistic activity and anti-endometriotic effects than Asoprisnil in preclinical studies.
Conclusions:
- Current SPRMs have limitations for endometriosis treatment.
- Novel mesoprogestins like EC313 exhibit promising preclinical profiles.
- Further investigation of next-generation mesoprogestins is warranted for endometriosis and related disorders.
