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Effects of triptorelin versus placebo on the symptoms of endometriosis
A Bergqvist1, T Bergh, L Hogström
1Department of Obstetrics and Gynecology, Malmö University Hospital, Sweden.
Objective:
To compare the effect of a GnRH-agonist, triptorelin, versus placebo on the symptoms of endometriosis.
Design:
A prospective, randomized, double-blind study of 6 months of treatment followed by 12 months of follow-up.
Setting:
Departments of Obstetrics and Gynecology at two universities and one general hospital.
Patient(S):
Forty-nine women with symptoms of laparoscopically verified endometriosis.
Intervention(S):
Triptorelin depot or placebo was given every 4 weeks. Clinical evaluation, including the Duration Intensity Behavior Scale and Visual Analogue Scale for pain, was performed before the injections and up to 12 months after treatment. A control laparoscopy was performed 4-6 weeks after the last injection.
Main Outcome Measure(S):
Quantitation of pain.
Result(S):
Twenty-four patients had active treatment and 25 received placebo. Pain symptoms according to both scales were significantly more reduced after 2 months of triptorelin treatment compared to placebo. The extent of endometriotic lesions was reduced 50% during triptorelin treatment and increased 17% during placebo. The average area of endometriotic lesions was reduced 45% during triptorelin treatment but was unchanged during placebo. Side effects, mainly hot flushes, were experienced by 80% of the actively treated group but also by 33% of patients in the placebo group. Because of recurrent symptoms, only five patients could be observed for 12 months after completion of treatment.
Conclusion(S):
Triptorelin reduces endometriotic lesions and pain to a significantly higher degree than placebo.