A pilot study on the use of andrographolide to treat symptomatic adenomyosis

In: Gynecology and Minimally Invasive Therapy · 2014 · vol. 3(4) , pp. 119–126 · doi:10.1016/j.gmit.2014.12.002 · W1976534292
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This pilot study found andrographolide improved symptomatic adenomyosis in some patients, particularly those with higher endometrial NF-κB p65 activation.

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Abstract

To evaluate the efficacy of andrographolide in treating adenomyosis and to test the hypothesis that its efficacy may depend on the nuclear factor-kappa-light-chain enhancer of activated B cells (NF-κB) activation status in eutopic endometrium, which may be a proxy for the status in adenomyotic foci. Twenty-four patients with transvaginal ultrasound-confirmed adenomyosis (excluding ovarian endometriomas) were recruited for this study after informed consent. All patients had dysmenorrhea and/or heavy menstrual bleeding. All received andrographolide pill orally for 3 months and were followed up for an additional 3 months. The primary outcome measures included the severity of dysmenorrhea, as measured by the visual analog scale (VAS), and menstrual characteristics, such as the amount of menses, all measured before and 3 and 6 months after the drug treatment. In addition, the patients completed Clinical Global Impression rating scales at the end of the 6 th month. Immunostaining of the phosphorylated NF-κB p65 (p-p65) subunit was also performed for eutopic endometrium. Andrographolide treatment appeared to be well tolerated by the patients. Six months after taking andrographolide, the average dysmenorrhea VAS score was decreased from the baseline level of 5.3 to 3.5. Twelve patients (50.0%) reported “marked” or “much” improvement, seven (29.2%) reported “minimal improvement” and five (20.8%) reported “unchanged or worse”. The eutopic endometrial p-p65 staining levels were closely correlated with the satisfaction rating. Andrographolide is effective in some patients with symptomatic adenomyosis, who have a higher endometrial expression of the activated form of the NF-κB p65 subunit. Future independent validation studies or randomized clinical trials may be needed to more precisely evaluate the efficacy of andrographolide.

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Outcome instruments

VAS-pain

Condition tags

adenomyosisdysmenorrhea

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