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

Margatho D, Deborah Margatho, Mota Carvalho N, Nelsilene Mota Carvalho, Larissa Eloy, Eloy L, Luis Bahamondes, Bahamondes L, 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
RCT OA: closed CC0 ⤵ 8 in-corpus citations
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This randomized trial found that both the etonogestrel implant and 52 mg LNG-IUS significantly reduced serum soluble CD23 and endometrial nerve fiber density in women with endometriosis-associated pain.

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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

endometriosischronic_pelvic_paindysmenorrhea

MeSH descriptors

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

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (41)

Cited by (8)

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