Impact of Elagolix on Quality of Life Among Endometriosis Patients: A Pooled Analysis of 2 Phase III Clinical Trials [13J]

In: Obstetrics & Gynecology · 2019 · vol. 133(1) , pp. 110 · doi:10.1097/01.aog.0000558829.95268.69 · W2944173553
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Elagolix treatment in women with endometriosis significantly improved health-related quality of life scores, including pain, control, emotional well-being, social support, self-image, and sexual intercourse, compared to placebo.

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This pooled analysis of two phase III randomized controlled trials evaluated the impact of elagolix, an oral gonadotropin-releasing hormone antagonist, on health-related quality of life in premenopausal women with moderate to severe endometriosis-associated pain. The study utilized data from 1686 patients who received either a once-daily or twice-daily dose of elagolix or placebo, assessing changes across six Endometriosis Health Profile scales at baseline, month three, and month six. Results demonstrated that both elagolix doses significantly improved all quality of life domains compared to placebo in a dose-dependent manner, with sustained benefits observed at six months for most scales except self-image and sexual intercourse. This paper is centrally about endometriosis — specifically evaluating the efficacy of a GnRH antagonist on patient-reported outcomes and quality of life metrics.

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Abstract

INTRODUCTION: Endometriosis-associated symptoms are associated with reduction in health-related quality of life (HRQL). This analysis evaluated the impact of Elagolix, an oral gonadotrophin releasing-hormone antagonist, on the HRQL of women with moderate to severe pain associated with endometriosis. METHODS: Data were pooled from two phase III randomized, placebo-controlled trials of elagolix (150mg once daily “Elagolix QD” or 200 mg twice daily “Elagolix BID”) in premenopausal women with moderate-to-severe endometriosis-associated pain. The Endometriosis Health profile (EHP-30), HRQL questionnaire was administered at baseline and months 1, 3 and 6 of treatment. Changes in the 5 core scales (pain, control and powerlessness, social support, emotional well-being, and self-image) and sexual intercourse modular scale scores of EHP-30 from baseline to month 3 and 6 were compared between each Elagolix dose and placebo using ANCOVA models that controlled for baseline scores. RESULTS: Final sample included 1686 patients. Both doses of elagolix exhibited a significantly greater reduction in all 6 scale scores than placebo (lower scores indicate better HRQL) at Month 3 in a dose-dependent fashion (pain: -18.49, -26.79, -35.59; control and powerlessness:-24.86, -32.81, -42.28; emotional well-being:-13.67, -17.75, -21.15; social support: -12.54, -18.0, -24.14; self-image:-11.16, -16.54, -21.08 and sexual intercourse: -13.54, -17.22 and -25.85 for placebo, Elagolix QD and Elagolix BID respectively; P <0.05 for all Elagolix group comparisons to placebo). Larger reductions were also observed for Elagolix groups at month 6 which were statistically significant for all scales except for self-image and sexual intercourse. CONCLUSION: Elagolix significantly improves HRQL among women with moderate to severe pain associated with endometriosis.
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Introduction

Endometriosis-associated symptoms are associated with reduction in health-related quality of life (HRQL). This analysis evaluated the impact of Elagolix, an oral gonadotrophin releasing-hormone antagonist, on the HRQL of women with moderate to severe pain associated with endometriosis.

Methods

Data were pooled from two phase III randomized, placebo-controlled trials of elagolix (150mg once daily “Elagolix QD” or 200 mg twice daily “Elagolix BID”) in premenopausal women with moderate-to-severe endometriosis-associated pain. The Endometriosis Health profile (EHP-30), HRQL questionnaire was administered at baseline and months 1, 3 and 6 of treatment. Changes in the 5 core scales (pain, control and powerlessness, social support, emotional well-being, and self-image) and sexual intercourse modular scale scores of EHP-30 from baseline to month 3 and 6 were compared between each Elagolix dose and placebo using ANCOVA models that controlled for baseline scores.

Results

Final sample included 1686 patients. Both doses of elagolix exhibited a significantly greater reduction in all 6 scale scores than placebo (lower scores indicate better HRQL) at Month 3 in a dose-dependent fashion (pain: -18.49, -26.79, -35.59; control and powerlessness:-24.86, -32.81, -42.28; emotional well-being:-13.67, -17.75, -21.15; social support: -12.54, -18.0, -24.14; self-image:-11.16, -16.54, -21.08 and sexual intercourse: -13.54, -17.22 and -25.85 for placebo, Elagolix QD and Elagolix BID respectively; P <0.05 for all Elagolix group comparisons to placebo). Larger reductions were also observed for Elagolix groups at month 6 which were statistically significant for all scales except for self-image and sexual intercourse.

Conclusion

Elagolix significantly improves HRQL among women with moderate to severe pain associated with endometriosis.

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Outcome instruments

EHP-30

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endometriosis

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