Immunomodulators and aromatase inhibitors: are they the next generation of treatment for endometriosis?

Abstract

Purpose of review: This article will present an overview of current and new hormonal and non-hormonal medical treatment in the management of endometriosis, with special emphasis on immunomodulators and aromatase inhibitors.

Recent findings: Recent research shows a very promising role for new hormonal medication (aromatase inhibitors, estrogen and progesterone receptor modulators) and anti-inflammatory drugs (tumor necrosis factor-alpha inhibitors, matrix metalloproteinase inhibitors, cyclooxygenase-2 inhibitors) in the management of endometriosis.

Summary: The ideal drug in the treatment of endometriosis alleviates pain and cures sub-fertility without inhibition of ovulation or menstruation and without significant side effects or teratological effects. Such a drug would allow conception during treatment and would fundamentally change the management of endometriosis from a surgical approach to medical management. Although such a drug does not yet exist, promising research using tumor necrosis factor inhibitors indicates that this could become possible in the not too distant future. We strongly recommend testing new medication for the prevention or treatment of endometriosis in the baboon model, an established research model for fundamental and preclinical research in endometriosis.