{"paper_id":"e39c6bb0-2ddb-4a11-a8c5-528fcd733c16","body_text":"ORAL GONADOTROPIN-RELEASING HORMONE ANTAGONISTS IN THE MANAGEMENT OF ENDOMETRIOSIS-ASSOCIATED PAIN: A COMPREHENSIVE REVIEW OF CLINICAL EFFICACY, SAFETY AND SOCIOECONOMIC IMPACT\nDOI:\nhttps://doi.org/10.31435/ijitss.1(49).2026.4988Keywords:\nEndometriosis, GnRH Antagonists, Elagolix, Relugolix, Linzagolix, Pelvic PainAbstract\nEndometriosis is a chronic, estrogen-dependent inflammatory disorder that affects approximately 10% of women of reproductive age, resulting in chronic pelvic pain and infertility. The principal clinical challenge is the management of endometriosis-associated pain (EAP), which substantially impairs quality of life and professional productivity. Conventional pharmacological treatments frequently provide inadequate relief or are constrained by significant adverse effects. Elagolix, relugolix, and linzagolix represent a newly developed class of oral non-peptide GnRH antagonists that have recently expanded the therapeutic landscape. Recent studies underscore the essential role of hormonal add-back therapy (ABT) in facilitating long-term management by preserving bone mineral density while suppressing pain. This review synthesizes current clinical data from major trials (ELARIS, SPIRIT, and SELECT) to evaluate the efficacy of these agents and examines their socio-technological impact, specifically how they reduce the socioeconomic burden of the disease and enhance patient autonomy and quality of life.\nReferences\nAs-Sanie, S., Black, R., Giudice, L. C., Gray, D. G., Jensen, J. T., Krance, J. P., Williams, A. T., & Soliman, A. M. (2024). The economic and humanistic burden of endometriosis: A systematic review. Journal of Managed Care & Specialty Pharmacy, 30 (2), 112–125. https://doi.org/10.18553/jmcp.2024.30.2.112\nBecker, C. M., Bokor, A., Heikinheimo, O., Jawadawy, A., Lukic, A., Murphy, K., Peterson, C., Schultze-Mosgau, M. H., Siebert, U., & Taylor, H. S. (2022). Linzagolix with and without add-back therapy for endometriosis-associated pain: Two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials (SELECT 1 and SELECT 2). The Lancet, 399 (10335), 1643–1655. https://doi.org/10.1016/S0140-6736 (22)00622-0\nDonnez, J., Giudice, L. C., Taylor, H. S., Lukes, A. S., Zivny, J. H., Anderson, C., Gay, S. G., Williams, G. C., & Wagman, R. B. (2023). Long-term efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: 2-year results from the SPIRIT open-label extension study. Human Reproduction, 38 (8), 1512–1524. https://doi.org/10.1093/humrep/dead105\nGiudice, L. C., As-Sanie, S., Arjona Ferreira, J. C., Becker, C. M., Abrao, M. S., Lessey, B. A., Brown, E., Sadek, S. J., Wagman, R. B., & Taylor, H. S. (2022). 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(2011). Impact of endometriosis on quality of life and work productivity: A multicenter study across 10 countries. Fertility and Sterility, 96 (2), 366–373. https://doi.org/10.1016/j.fertnstert.2011.05.090\nOsuga, Y., Seki, Y., Tanimoto, M., & Kusumoto, T. (2023). Long-term safety and efficacy of elagolix for endometriosis-associated pain: A comprehensive pharmacological review. Expert Review of Clinical Pharmacology, 16 (11), 1045–1058. https://doi.org/10.1080/17512433.2023.2271036\nSimani, L., Taylor, H. S., & Zito, G. (2024). Oral GnRH antagonists for endometriosis: A systematic review and network meta-analysis of clinical efficacy and safety. Fertility and Sterility, 121 (3), 412–425. https://doi.org/10.1016/j.fertnstert.2023.12.015\nTaylor, H. S., Giudice, L. C., Lessey, B. A., Abrao, M. S., Kotarski, J., Archer, D. F., Diamond, M. P., Surrey, E. S., Orzeck, N. G., & Watts, N. B. (2017). Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist. 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Diagnostics, 13 (4), 724. https://doi.org/10.3390/diagnostics13040724\nDownloads\nPublished\nIssue\nSection\nLicense\nCopyright (c) 2026 Maria Kurt, Norbert Gromadzki, Grzegorz Jałoszyński, Sebastian Konecki, Oliwia Marciniak, Natalia Bylak, Bruno Makowski, Maciej Makarewicz, Marcin Patryk Barbachowski, Anna Gwizdek, Dawid Szczepański\nThis work is licensed under a Creative Commons Attribution 4.0 International License.\nAll articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.\nCC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.","source_license":"CC0","license_restricted":false}