Assessment of biomarkers in women with endometriosis-associated pain using the ENG contraceptive implant or the 52 mg LNG-IUS: a non-inferiority randomised clinical trial

Deborah Margatho, Nelsilene Mota Carvalho, Larissa Eloy, Luis Bahamondes, Luís Bahamondes
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception · 2018 · vol. 23(5) , pp. 344–350 · doi:10.1080/13625187.2018.1531117 · PMID:30372645 · W2899017057
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Abstract

OBJECTIVE: The aim of the study was to assess the serum levels of the following biomarkers in women with endometriosis-associated pelvic pain before and after six months of using the etonogestrel (ENG) contraceptive implant or the 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS): cancer antigen (CA)-125, cluster of differentiation (CD) 23 and endometrial nerve fibre density. METHODS: The study was conducted at the Department of Obstetrics and Gynaecology, University of Campinas Medical School, Brazil. A total of 103 women with endometriosis-associated pain diagnosed by surgery, transvaginal ultrasound and/or magnetic resonance imaging were included. Endometrial nerve fibre density and serum levels of CA-125 and soluble CD23 were assessed before and after six months of using the allocated method and were correlated to 10 cm visual analogue scale (VAS) scores for non-cyclical pelvic pain and dysmenorrhoea. RESULTS: Both contraceptive methods significantly reduced concentrations of serum soluble CD23 and endometrial nerve fibre density (p < .001); however, CA-125 was significantly reduced only among users of the ENG implant (p < .05). No correlation was observed between reduction of biomarkers and improvement of VAS pain and dysmenorrhoea scores. No differences were observed between the ENG implant and the LNG-IUS. CONCLUSION: Both progestin-only contraceptives significantly reduced two out of the three biomarkers evaluated. These two biomarkers could, therefore, be used as surrogate markers to follow up medical treatment of endometriosis-associated pain.

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Outcome instruments

VAS-pain

Condition tags

mesh:D004715mesh:D017699endometriosisdysmenorrhea

MeSH descriptors

Contraceptive Agents, Female Desogestrel Endometriosis Levonorgestrel Pelvic Pain Adult Biomarkers Biomarkers Brazil CA-125 Antigen CA-125 Antigen Contraceptive Agents, Female Desogestrel Drug Implants Drug Implants Endometriosis Endometriosis Endometriosis Endometrium Endometrium

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