title: Nafarelin vs. leuprolide acetate depot for endometriosis. Changes in bone mineral density and vasomotor symptoms. Nafarelin Study Group.
abstract: OBJECTIVE
  To compare intranasal nafarelin and intramuscular leuprolide acetate (LA) depot in the management of endometriosis.
  
  
  METHODS
  A multicenter, prospective, randomized, double-placebo, double-blind study was conducted on subjects who had symptoms and signs of endometriosis and bone mineral density (BMD) within the age-appropriate normal range. For 6 months, 99 subjects received nafarelin, 200 micrograms twice daily, and placebo injections once monthly; 93 subjects received LA depot injections, 3.75 mg once monthly, and placebo nasal spray, twice daily. Subjects were followed throughout treatment and for six months after treatment. The main outcome measures were changes in endometriosis symptoms and signs, BMD measurements, subject-reported and objectively measured hot flushes and circulating estradiol concentrations.
  
  
  RESULTS
  Nafarelin was as effective as LA depot in alleviating symptoms and signs of endometriosis. LA depot recipients lost significantly more BMD, had more days with subjective hot flushes and more objectively measured hot flushes than did nafarelin recipients. In the nafarelin group, estradiol levels were consistently higher than in the leuprolide depot group, with significant differences by month 3 of dosing.
  
  
  CONCLUSIONS
  Nafarelin and LA depot were equally effective despite higher estradiol levels in nafarelin recipients. Nafarelin-treated subjects lost less BMD, had fewer days with hot flushes and had fewer objectively measured hot flushes.
authors.affiliation: Department of Obstetrics and Gynecology, Cedara-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Agarwal
authors.forename: C
authors.initials: C
authors.lastname: Hamrang
authors.forename: M R
authors.initials: MR
authors.lastname: Henzl
authors.forename: H L
authors.initials: HL
authors.lastname: Judd
mesh_terms: D000328:Adult; D015519:Bone Density; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D004715:Endometriosis / Q000188:drug therapy* / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017274:Nafarelin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010053:Ovary / Q000503:physiopathology; D010919:Placebos; D011446:Prospective Studies; D014666:Vasomotor System
chemical_list: D003692:Delayed-Action Preparations; D010919:Placebos; D017274:Nafarelin; D004958:Estradiol; D016729:Leuprolide