Mifepristone following conservative surgery in the treatment of endometriosis

Objective To compare the efficacy and safety of mifepristone and danazol after conservative surgery in the treatment of patients with endometriosis Methods Sixty one patients with endometriosis (RAFS stage Ⅰ～Ⅳ) after conservative surgery were treated orally either with mifepristone 10 mg/d (group M, n =31) or danazol 200 mg 2～3 times/d (group D, n =30) for 3 months Changes of symptoms and signs, serum reproductive hormone levels as well as side effects were assessed before and at the end of therapy Moreover, biochemical parameters of bone metabolism: urinary deoxypyridine /creatinine (UDpd/Cr),serum alkaline phosphatase (AKP) and bone gala protein (BGP) were also measured before and after treatments Results During treatment symptoms and signs were remarkbly relieved in both groups Side effects including hot flushes, irregular vaginal bleeding, back pain, weight gain and acne, were less commnly seen in group M as compared with group D Serum luteal hormone (LH), follicular stimulating homone (FSH) levels remained in the range of follicular phase in both groups So was serum estradiol (E 2) levels in group M[(204 9±45 3 ) pmol/L], but declined to postmenopausal level in group D [(94 3±33 0) pmol/L] About two weeks after discontinuation of the thrapy, serum E 2 levels [(1 221 6± 384 2) pmol/L] was not significantly different from the normal ovulatory range in group M, but significantly lower in group D [(815 1±376 0) pmo/L, P 0 05] So were the serum progesterone levels at mid luteal phase [(33 1±5 6) nmol/L Vs (27 4±4 9) nmol/L] There were no significant changes of biochemical parameters of bone metabolism before and at the end of treatment except significant increases of serum AKP and BGP in group D Conclusions Mifepristone is equally effective to danazol when combined with conservative surgery in the management of endometriosis with fewer side effects Serum E 2 levels remained in the range of follicular phase No impact on the bone turnover after 3 months of therapy was found