A randomized, comparative trial of triptorelin depot (D-Trp6-LHRH) and danazol in the treatment of endometriosis.
To compare treatment efficacy and safety parameters a total of 55 premenopausal women with histologically proven endometriosis (stage II-IV) were randomized to receive the LHRH-analogue depot triptorelin (n = 30) or the steroid danazol (n = 25) for a total of 24 weeks. Immediately after cessation of the endocrine therapy a second-look operation was performed. Four as well as 24 weeks after the end of treatment patients were seen for re-evaluation of clinical symptoms and safety parameters. Estradiol suppression was significantly more pronounced with triptorelin, while the free androgenic index rose with danazol. Both substances were equally effective in reducing endometriotic implants (58% and 51%, respectively). Dysmenorrhea was absent at the end of medical therapy in both treatment groups. Dyspareunia and pelvic pain decreased at least by 50%. Red blood count, thrombocytes, liver enzymes and the atherogenic index rose with danazol, while the urinary calcium/creatinine ratio showed a marked elevation with triptorelin. Adverse effects were mainly due to the hypoestrogenism of the LHRH analogue and the androgenic/anabolic properties of the steroid. Triptorelin and danazol are equally effective in treating endometriosis. Therefore, choice of treatment should be based on the patient's medical history and the pharmacological profile of each substance.
Cirkel
U
U
Universitätsfrauenklinik Münster, Germany.
Ochs
H
H
Schneider
H P
HP
D000328:Adult; D003613:Danazol / Q000009:adverse effects / Q000627:therapeutic use*; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D003692:Delayed-Action Preparations; D004412:Dysmenorrhea / Q000188:drug therapy; D004414:Dyspareunia / Q000188:drug therapy; D004715:Endometriosis / Q000188:drug therapy* / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008183:Luteal Phase / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D017699:Pelvic Pain / Q000188:drug therapy; D011374:Progesterone / Q000097:blood; D017329:Triptorelin Pamoate / Q000009:adverse effects / Q000627:therapeutic use*; D014592:Uterine Hemorrhage / Q000139:chemically induced
D003692:Delayed-Action Preparations; D017329:Triptorelin Pamoate; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D003613:Danazol