Comparison of the hemostatic effects of a levonorgestrel-releasing intrauterine system and leuprolide acetate in women with endometriosis: A randomized clinical trial

Erciliene M M Yamaguti, Yamaguti EM, E. M. M. Yamaguti, Milena Bastos Brito, Brito MB, Milena B Brito, Rui Alberto Ferriani, Rui A Ferriani, Ferriani RA, Garcia AA, Andrea Aparecida Garcia, Andréa A Garcia, Júlio C Rosa-e-Silva, Rosa-e-Silva JC, Júlio César Rosa e Silva, Carolina S Vieira, Carolina Sales Vieira
Thrombosis research · 2014 · vol. 134(6) , pp. 1193–1197 · doi:10.1016/j.thromres.2014.09.014 · PMID:25283586 · W2163447346
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This randomized clinical trial compared the hemostatic effects of a levonorgestrel-releasing intrauterine system and leuprolide acetate in women with endometriosis.

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Abstract

IntroductionThe hemostatic and inflammatory systems may activate each other. Endometriosis is a chronic inflammatory disease affecting 10% of women. The objective of this study was to compare the hemostatic effects of two treatments widely prescribed to women with endometriosis: the levonorgestrel intrauterine system (LNG-IUS) and the gonadotropin-releasing hormone analog (GnRHa) leuprolide acetate.Materials and methodsIn this randomized open-label controlled trial, 44 women with endometriosis were randomly allocated to one of two groups: 22 women were assigned to use LNG-IUS and 22 to use GnRHa. The assessed variables were D-dimers, fibrinogen, prothrombin time, activated partial thromboplastin time, coagulation factors (F) II, V, VII, VIII, IX, X, and XI, antithrombin (AT), protein C, free protein S, tissue plasminogen activator (t-PA), α2-antiplasmin, thrombin-antithrombin complex, and prothrombin fragment 1+2. All variables were assessed before treatment and six months after treatment onset.ResultsIn the LNG-IUS group, FVIII decreased 10% after six months of use. In the GnRHa group, there was a 6% increase in AT, 29% reduction in D-dimers, and 19% increase in t-PA. The LNG-IUS users exhibited a significantly greater reduction of FVIII than the GnRHa users (LNG-IUS: -6.4 ± 14.3% vs. GnRHa: 4.2 ± 12.3%, p=0.02). The women in the GnRHa group exhibited a greater increase of AT than the LNG-IUS users (LNG-IUS: -0.7 ± 9.5% vs. GnRHa: 6.5 ± 10.1%, p=0.02).ConclusionBoth hormonal treatments for endometriosis exhibited no association with a procoagulant profile.

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Condition tags

endometriosis

MeSH descriptors

Blood Coagulation Endometriosis Endometriosis Hemostasis Leuprolide Levonorgestrel Adolescent Adult Blood Coagulation Contraceptive Agents, Female Contraceptive Agents, Female Delayed-Action Preparations Delayed-Action Preparations Endometriosis Endometriosis Female Fertility Agents, Female Fertility Agents, Female Hemostasis Hemostatics

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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