Human issues and medical economics of endometriosis. Three- vs. six-month GnRH-agonist therapy
1Department of Gynecology and Obstetrics, Stanford University School of Medicine, CA 94305, USA.
Objective:
To project the efficacy and economic consequence of short-term intranasal gonadotropin-releasing hormone agonist (GnRH-a) for diagnosis of and therapy for endometriosis.
Study Design:
Multicenter, placebo-controlled clinical trials of GnRH-a comparing three vs. six months of treatment, three months of retreatment and three months of postoperative treatment for the symptoms and signs of laparoscopically diagnosed endometriosis.
Results:
The reduction in symptoms and signs of endometriosis was similar at the end of three months to the relief at six months. Retreatment was as effective as initial treatment, and the return of symptoms after laparoscopic surgery plus postoperative treatment for three months was delayed by approximately 18 months as compared to surgery alone. The projected charges for the surgical approaches (laparoscopy or minilaparoscopy) to diagnosis and therapy were 50-60% greater than those for the medical approach.
Conclusion:
GnRH-a administration for three months could be a cost-effective approach to the presumptive diagnosis and treatment of endometriosis among women with chronic pelvic pain.
