Retreatment with nafarelin for recurrent endometriosis symptoms: efficacy, safety, and bone mineral density

Abstract

Objective: To assess the efficacy, safety, and effect on bone mineral density of a 3-month course of retreatment with intranasal nafarelin acetate for recurrent symptoms of endometriosis.

Design: Multicenter, open-label, nonrandomized clinical trial.

Setting: Eleven hospital-based and private practices.

Patient(s): Thirty-six women with endometriosis symptoms recurring after 3 or 6 months of treatment with nafarelin.

Intervention(s): Nasal nafarelin 200 micrograms twice daily for 3 months.

Main outcome measure(s): Assessments for dysmenorrhea, dyspareunia, pelvic pain, tenderness, and induration. Measurement of bone mineral density of the lumbar spine.

Result(s): Improvements from admission to the end of retreatment were significant for dysmenorrhea, pelvic pain, tenderness, induration, and dyspareunia. Three months after retreatment ended, mean symptom scores for dysmenorrhea and pelvic tenderness, although worse than at the end of retreatment, were still significantly better than scores at admission. Mean bone mineral density 3 months after retreatment was 0.56% lower than before retreatment and 1.94% lower than before initial treatment.

Conclusion(s): Three-month nafarelin retreatment for recurrent endometriosis symptoms was effective and safe.