Evaluation of Endpoints Used in Clinical Trials on Adenomyosis - A Systematic Review

Kiran Kumar Rathinam, Rathinam KK, Abraham JJ, Justin Jacob Abraham, Karuppaiah H, Harish Karuppaiah, Selvaraj HP, Heema Preethy Selvaraj, Sunita Samal, Samal S, George M, Melvin George
Reviews on recent clinical trials · 2023 · vol. 18(2) , pp. 83–91 · doi:10.2174/1574887118666230329104546 · PMID:36999412 · W4361268039
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This systematic review of adenomyosis clinical trials found that LNG-IUS and dienogest were the most evaluated drugs, with pain and bleeding severity, uterine volume, and estradiol levels being common endpoints.

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This systematic review assessed the state of interventional clinical research for adenomyosis drug therapy from 2001–2021 by searching PubMed and ClinicalTrials.gov without time or language limits, focusing on which trial endpoints were used. It found that barely 15 drugs had been evaluated for adenomyosis management during that period, with LNG-IUS being the most studied followed by dienogest, and that common endpoints included VAS/NPRS pain measures, hemoglobin and PBAC for menstrual bleeding, uterine volume, and serum estradiol. The authors highlight a limitation in endpoint coverage by suggesting that a comprehensive scoring system incorporating all disease symptoms and objective elements is needed. Relevance to endometriosis: adenomyosis is closely related to endometriosis clinically and was included here as a condition central to pelvic pain research, though the paper itself is centrally about adenomyosis rather than endometriosis-specific mechanisms.

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Abstract

Adenomyosis lacks approved pharmacological treatment even after decades of its identification. We performed this study to review the status of clinical research on adenomyosis for finding an effective drug therapy and to identify the most common endpoints used in adenomyosis trials. A systematic search was performed in the PubMed and Clinicaltrials.gov registries to identify interventional trials for analysis without any time and language restrictions. Our search revealed that barely 15 drugs have been assessed for the management of adenomyosis from 2001 to 2021. Among these, LNG-IUS was found to be the most evaluated drug, followed by dienogest. In these trials, the most commonly assessed endpoints included VAS, NPRS for pain, haemoglobin and PBAC for menstrual bleeding, uterine volume, and serum estradiol. There appears to be a need for developing a comprehensive score that takes into consideration all disease symptoms as well as incorporates some objective elements to evaluate the disease.
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Abstract

Adenomyosis lacks approved pharmacological treatment even after decades of its identification. We performed this study to review the status of clinical research on adenomyosis for finding an effective drug therapy and to identify the most common endpoints used in adenomyosis trials. A systematic search was performed in the PubMed and Clinicaltrials.gov registries to identify interventional trials for analysis without any time and language restrictions. Our search revealed that barely 15 drugs have been assessed for the management of adenomyosis from 2001 to 2021. Among these, LNG-IUS was found to be the most evaluated drug, followed by dienogest. In these trials, the most commonly assessed endpoints included VAS, NPRS for pain, haemoglobin and PBAC for menstrual bleeding, uterine volume, and serum estradiol. There appears to be a need for developing a comprehensive score that takes into consideration all disease symptoms as well as incorporates some objective elements to evaluate the disease.

Keywords

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Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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