Long-acting triptorelin for the treatment of endometriosis.
OBJECTIVE
To evaluate the efficacy and adverse effects of monthly triptorelin injection for the treatment of endometriosis.


METHODS
A multicenter clinical trial including 45 women with endometriosis, treated with triptorelin 3.75 mg i.m. every 4 weeks in six consecutive doses. The main outcome measures were symptom relief, reduction according to revised American Fertility Society (rAFS) scores, reduction in size of ovarian endometrioma, effects on hormone and lipid profiles, changes in bone mineral density (BMD), adverse effects, and return of menstruation. Data were analyzed using repeated measures analysis of variance and paired t-tests.


RESULTS
Pain-related symptoms decreased in all cases after 8 weeks of treatment. Laparoscopic assessment revealed a reduction in rAFS scores in 21 out of 25 cases (mean pretreatment scores 43.44 +/- 5.75 vs. post-treatment scores 22.30 +/- 3.40, P < 0.001). The size of ovarian endometrioma decreased in eight of nine women but none disappeared. Serum luteinizing hormone, follicle-stimulating hormone and estradiol levels were effectively suppressed during treatment. A slight increase in cholesterol and triglyceride levels was observed but all values were within normal limits. After 24 weeks of treatment there was a slight decrease in BMD of total body, lumbar vertebrae and femoral neck but not radius. The main adverse effects included hot flushes, night sweating, vaginal dryness, headache, dizziness and nausea Menstruation returned 83.76 +/- 2.91 days after the last injection of triptorelin.


CONCLUSIONS
Long-acting triptorelin is efficacious in the treatment of endometriosis and has tolerable side effects.
Department of Obstetrics and Gynecology, Ramathibodi Hospital, Bangkok, Thailand.
W
W
Choktanasiri
W
W
Boonkasemsanti
T
T
Sittisomwong
S
S
Kunathikom
S
S
Suksompong
U
U
Udomsubpayakul
A
A
Rojanasakul
D000328:Adult; D015519:Bone Density; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D004715:Endometriosis / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007273:Injections, Intramuscular; D010049:Ovarian Diseases / Q000175:diagnosis / Q000188:drug therapy*; D017329:Triptorelin Pamoate / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D003692:Delayed-Action Preparations; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone