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. 2023 Oct;308(4):1047-1056.
doi: 10.1007/s00404-022-06862-0. Epub 2023 Jan 19.

Efficacy and safety of oral gonadotropin-releasing hormone antagonists in moderate-to-severe endometriosis-associated pain: a systematic review and network meta-analysis

Lingli Xin #  1 , Yinghao Ma #  2 , Mei Ye  3 , Ling Chen  3 , Fuzhou Liu  4 , Qingxiang Hou  5
Affiliations

Efficacy and safety of oral gonadotropin-releasing hormone antagonists in moderate-to-severe endometriosis-associated pain: a systematic review and network meta-analysis

Lingli Xin et al. Arch Gynecol Obstet. 2023 Oct.

Abstract

Purpose: The aim of this NMA is to comprehensively analyze evidence of oral GnRH antagonist in the treatment of moderate-to-severe endometriosis-associated pain.

Methods: Literature searching was performed to select eligible studies published prior to April 2022 in PubMed, Cochrane, Embase and Web of Science. Randomized controlled trials involving patients who suffered from moderate-to-severe endometriosis-associated pain and treated with oral nonpeptide GnRH antagonists or placebo were included.

Results: Elagolix 400 mg and ASP1707 15 mg were most efficient in reducing pelvic pain, dysmenorrhea and dyspareunia. Relugolix 40 mg was best in reducing the analgesics use. The rates of any TEAEs and TEAEs-related discontinuation were highest in relugolix 40 mg and elagolix 250 mg, respectively, while rates of hot flush and headache were highest in relugolix 40 mg and elagolix 150 mg. Significantly decreased spinal BMD was observed in elagolix 250 mg.

Conclusion: Oral GnRH antagonists were effective in endometriosis-associated pain in 12w, and most of the efficiency and safety outcomes were expressed in a dose-dependent manner, but linzagolix 75 mg was an exception.

Keywords: Efficiency; Endometriosis; Oral GnRH antagonists; Pain; Safety.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

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Flowchart of literature searching
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Risk of bias assessment
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Assessment of pain related outcomes
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Assessment of safety related outcomes
See this image and copyright information in PMC

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