Human issues and medical economics of endometriosis. Three- vs. six-month GnRH-agonist therapy.
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Three months of GnRH-agonist treatment effectively reduced endometriosis symptoms and signs, representing a cost-effective alternative to surgery for chronic pelvic pain.
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Abstract
OBJECTIVE: To project the efficacy and economic consequence of short-term intranasal gonadotropin-releasing hormone agonist (GnRH-a) for diagnosis of and therapy for endometriosis. STUDY DESIGN: Multicenter, placebo-controlled clinical trials of GnRH-a comparing three vs. six months of treatment, three months of retreatment and three months of postoperative treatment for the symptoms and signs of laparoscopically diagnosed endometriosis. RESULTS: The reduction in symptoms and signs of endometriosis was similar at the end of three months to the relief at six months. Retreatment was as effective as initial treatment, and the return of symptoms after laparoscopic surgery plus postoperative treatment for three months was delayed by approximately 18 months as compared to surgery alone. The projected charges for the surgical approaches (laparoscopy or minilaparoscopy) to diagnosis and therapy were 50-60% greater than those for the medical approach. CONCLUSION: GnRH-a administration for three months could be a cost-effective approach to the presumptive diagnosis and treatment of endometriosis among women with chronic pelvic pain.
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Cited by (15)
- Gonadotropin-Releasing Hormone (GnRH)/GnRH Receptors and Their Role in the Treatment of Endometriosis 2023
- Dienogest compared with gonadotropin‐releasing hormone agonist after conservative surgery for endometriosis 2016
- Treatment of Endometriosis with the GnRHa Deslorelin and Add-Back Estradiol and Supplementary Testosterone 2015
- Therapeutic Efficiency of Tibolone in a Rat Endometriosis Model 2011
- Dienogest in long-term treatment of endometriosis 2011
- Economic Perspective on Diagnosis and Treatment of Endometriosis 2011
- Gonadotrophin-releasing hormone analogues for pain associated with endometriosis 2010
- Patients' report on how endometriosis affects health, work, and daily life 2009
- Endometriosis: cost estimates and methodological perspective 2007
- Economic burden of endometriosis 2006
- Is helium thermal coagulator therapy for the treatment of women with minimal to moderate endometriosis cost-effective? A prospective randomised controlled trial 2005
- A life shaped by pain: women and endometriosis 2005
- Post-operative GnRH analogue treatment after conservative surgery for symptomatic endometriosis stage III–IV: a randomized controlled trial 2001
- A cost-effective approach to the management of endometriosis 2000
- Medical Treatment of Endometriosis 1999
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