Drug therapy for adenomyosis: a prospective, nonrandomized, parallel-controlled study

Abstract

Objective To provide novel insights into the clinical treatment of adenomyosis. Methods Two hundred patients with adenomyosis were enrolled in this prospective, nonrandomized, parallel-controlled study with a 1-year follow-up in our hospital. Group 1 was treated with 3.75 mg leuprorelin acetate (LA) (n = 40), Group 2 was treated with 1.88 mg LA (n = 40), Group 3 underwent Mirena implantation (n = 40), Group 4 underwent Mirena implantation after treatment with 3.75 mg LA (n = 40), Group 5 underwent Mirena implantation after treatment with 1.88 mg LA (n = 20), and Group 6 received San-Jie-Zhen-Tong capsules alone (n = 20). Uterine volume, pain, cancer antigen 125 level, ovary function, adverse effects, and Mirena expulsion were evaluated. Results The uterine volume and pain scores were lower in the groups treated with 1.88 than 3.75 mg LA, but the lower dose was associated with significantly fewer hot flashes and sweating. The 1-year Mirena expulsion rate was higher in Group 3 than in Groups 4 and 5 (10.00% vs. 3.33%, respectively). Costs were significantly higher in Groups 1 and 4 than in Groups 2 and 5. Conclusion Administration of 1.88 mg LA may be an alternative therapy for Asian patients with adenomyosis. The combination of LA and Mirena could enhance the therapeutic effect. Registration number: ChiCTR-IPR-15005971.

Keywords: Adenomyosis; Mirena; adverse effect; efficacy; gonadotropin-releasing hormone analogues; half-dose.

Figure 1.

Mean uterine volume in each group before and after treatment. Group 1, 3.75 mg leuprorelin acetate; Group 2, 1.88 mg leuprorelin acetate; Group 3, Mirena; Group 4, Mirena + 3.75 mg leuprorelin acetate; Group 5, Mirena + 1.88 mg leuprorelin acetate; Group 6, San-Jie-Zhen-Tong capsules

Figure 2.

Changes in VAS scores in each group before and after treatment. VAS, visual analogue scale. Group 1, 3.75 mg leuprorelin acetate; Group 2, 1.88 mg leuprorelin acetate; Group 3, Mirena; Group 4, Mirena + 3.75 mg leuprorelin acetate; Group 5, Mirena + 1.88 mg leuprorelin acetate; Group 6, San-Jie-Zhen-Tong capsules