Dienogest in the treatment of endometriosis: systematic review.
OBJECTIVE
Endometriosis is a prevalent disease that affects 5-15 % of women of reproductive age. The aim of this study is to assess the effect of dienogest in the treatment of endometriosis.


METHODS
The search was applied to electronic databases PubMed, Cochrane, EMBASE and Lilacs until September 2014, in a public tertiary hospital. We performed a systematic literature search of randomized trials comparing dienogest to other medical therapies in the treatment of endometriosis, as well as their references list, using the keywords "dienogest" and "endometriosis" by two independent authors. The data extraction were performed by two authors using predefined data fields. Nine randomized trials were included. Dienogest 2 mg/day was superior to placebo in reducing pelvic pain (27.4 versus 15.1 mm, P < 0.0001), with similar results to buserelin, leuprorelin, leuprolide acetate and triptorelin, in controlling symptoms associated with endometriosis. Dienogest 2 mg/day was effective in reducing endometriotic lesions (11.4 ± 1.71-3.6 ± 0.95, P < 0.001). The extended therapy with dienogest 2 mg/day also showed an improvement in pelvic pain after 24-52 weeks (-22.5 ± 32.1 and -28.4 ± 29.9 mm, respectively) with tolerable side effects.


CONCLUSIONS
Dienogest should be considered as an alternative for controlling symptoms related to endometriosis. Nevertheless, in this systematic review, no studies were found comparing dienogest with first-line therapy, such as progestins and estrogen-progestogen combinations, which are proved to be effective in the treatment of endometriosis, are less expensive, and also can be used for contraception.
Endometriosis Clinic, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, CEP, 05403-010, Brazil, marina.dpandres@gmail.com.
Marina de Paula
Mde P
Andres
Livia Alves
LA
Lopes
Edmund Chada
EC
Baracat
Sergio
S
Podgaec
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017699:Pelvic Pain / Q000188:drug therapy; D011372:Progestins / Q000627:therapeutic use*; D016896:Treatment Outcome
D006727:Hormone Antagonists; D011372:Progestins; C023635:dienogest; D009277:Nandrolone