Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis: a systematic review and meta-analysis.

Autor: de Souza Pinto LP; CITH-Integrated Hormone Treatment Center, Curitiba, PR, Brazil., Ferrari G; Iaso Biodelivery Fabricação de Dispositivos com Liberação de Fármacos LTDA, Florianópolis, SC, Brazil.; Biomechanics Engineering Laboratory, Department of Mechanical Engineering, University Hospital &, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.; Bio Meds Pharmaceutica LTDA, Florianópolis, SC, 88050-001, Brazil.; NIMMA-Núcleo de Inovação em Moldagem e Manufatura Aditiva, Department of Mechanical Engineering, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil., Dos Santos IK; State University of Rio Grande do Norte, Natal, Mossoró, RN, Brazil., de Mello Roesler CR; Biomechanics Engineering Laboratory, Department of Mechanical Engineering, University Hospital &, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil., de Mello Gindri I; Iaso Biodelivery Fabricação de Dispositivos com Liberação de Fármacos LTDA, Florianópolis, SC, Brazil. izabellegindri@hotmail.com.; Bio Meds Pharmaceutica LTDA, Florianópolis, SC, 88050-001, Brazil. izabellegindri@hotmail.com.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2023 Jan; Vol. 307 (1), pp. 21-37. Date of Electronic Publication: 2022 Nov 24.
DOI: 10.1007/s00404-022-06846-0
Abstrakt: 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.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE