Safety and Effectiveness of Dienogest (Visanne®) for Treatment of Endometriosis: A Large Prospective Cohort Study

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This prospective cohort study in 3356 Korean patients found that daily dienogest (Visanne®) treatment for endometriosis was safe, with a 13.27% adverse reaction rate, and effective in reducing pain.

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This large prospective Korean cohort study evaluated safety and effectiveness of dienogest 2 mg daily (Visanne) for endometriosis in 3356 patients across 73 centers, with follow-up for at least 6 months after enrollment. Adverse drug reactions were recorded for severity, timing, outcomes, treatments, and suspected causality, and effectiveness was assessed by change in visual analogue scale (VAS) for pain from baseline at last follow-up. ADR incidence was 13.27% (413/3113), with abnormal uterine bleeding, increased weight, and headache as the most frequent events, and amenorrhea rates increased over time; mean VAS change was −28.19 ± 28.39 mm (P < 0.0001). The study explicitly reflects routine clinical practice and uses a non-randomized cohort design, which limits causal inference compared with controlled trials. This paper is centrally about endometriosis—assessing the real-world safety and pain outcomes of dienogest treatment in a large prospective cohort.

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Abstract

Dienogest (DNG) is a progestin with highly selective progesterone activity and known to be effective in the treatment of endometriosis. This prospective cohort study in patients who had been treated with DNG 2 mg (Visanne®) for endometriosis was conducted to assess the safety and effectiveness of DNG in a large Korean cohort. This study included 3356 patients with endometriosis from 73 centers in Korea. All patients were treated with DNG 2 mg daily and were followed up for at least 6 months after initial visit. Any adverse events were recorded including severity, onset/closing date, outcomes, treatments, and the causality with DNG. Effectiveness of DNG was measured by changes in visual analogue scale (VAS) from baseline at the end of follow-up. The mean age of the subjects was 34.96 years, and the mean duration of treatment was 285.44 days. Incidence of adverse drug reaction (ADR) was 13.27% (413/3113). The most frequently reported ADR were "abnormal uterine bleeding" 4.14% (129/3113), "increased weight" 2.57% (80/3113), and "headache" 1.22% (38/3113). The number of patients (%) with favorable bleeding patterns was observed to increase as the duration of treatment increases. Amenorrhea was observed in 29.63%, 41.25%, 46.26%, and 53.20% of patients at 3 months, 6 months, 12 months, and more than 12 months follow-up period, respectively. The mean (±SD) VAS change from baseline at the last follow-up visit was -28.19 ± 28.39 mm (P value < 0.0001). This large cohort study confirms, in routine clinical practice, that DNG is safe and effective for treatment of endometriosis.
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Abstract

Dienogest (DNG) is a progestin with highly selective progesterone activity and known to be effective in the treatment of endometriosis. This prospective cohort study in patients who had been treated with DNG 2 mg (Visanne®) for endometriosis was conducted to assess the safety and effectiveness of DNG in a large Korean cohort. This study included 3356 patients with endometriosis from 73 centers in Korea. All patients were treated with DNG 2 mg daily and were followed up for at least 6 months after initial visit. Any adverse events were recorded including severity, onset/closing date, outcomes, treatments, and the causality with DNG. Effectiveness of DNG was measured by changes in visual analogue scale (VAS) from baseline at the end of follow-up. The mean age of the subjects was 34.96 years, and the mean duration of treatment was 285.44 days. Incidence of adverse drug reaction (ADR) was 13.27% (413/3113). The most frequently reported ADR were “abnormal uterine bleeding” 4.14% (129/3113), “increased weight” 2.57% (80/3113), and “headache” 1.22% (38/3113). The number of patients (%) with favorable bleeding patterns was observed to increase as the duration of treatment increases. Amenorrhea was observed in 29.63%, 41.25%, 46.26%, and 53.20% of patients at 3 months, 6 months, 12 months, and more than 12 months follow-up period, respectively. The mean (±SD) VAS change from baseline at the last follow-up visit was −28.19 ± 28.39 mm (P value < 0.0001). This large cohort study confirms, in routine clinical practice, that DNG is safe and effective for treatment of endometriosis. Similar content being viewed by others

References

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Sci. 27, 905–915 (2020). https://doi.org/10.1007/s43032-019-00094-5 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-019-00094-5

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endometriosis

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Endometriosis Hormone Antagonists Nandrolone Adult Endometriosis Endometriosis Female Hormone Antagonists Humans Middle Aged Nandrolone Nandrolone Pain Pain Pain Prospective Studies Treatment Outcome

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