Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain

William D. Schlaff, Schlaff WD, Carson SA, Sandra Ann Carson, Anthony Luciano, Anthony A. Luciano, Luciano A, Doug Ross, Ross D, Agneta Bergqvist, Bergqvist A
Fertility and sterility · 2006 · vol. 85(2) , pp. 314–325 · doi:10.1016/j.fertnstert.2005.07.1315 · PMID:16595206 · W2017780870
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This study compared the efficacy of subcutaneous depot medroxyprogesterone acetate to leuprolide acetate in alleviating endometriosis-associated pain.

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Abstract

ObjectiveTo compare the efficacy and safety of SC depot medroxyprogesterone acetate (DMPA-SC 104) with that of leuprolide acetate in treatment of endometriosis.DesignPhase 3, multicenter, randomized, evaluator-blinded, comparator-controlled trial.SettingClinical trial sites in Canada and United States.Patient(s)Two hundred seventy-four women with surgically diagnosed endometriosis.Intervention(s)Intramuscular injections of DMPA-SC (104 mg) or leuprolide acetate (11.25 mg), given every 3 months for 6 months, with 12 months of posttreatment follow-up.Main outcome measure(s)Reduction in five endometriosis symptoms or signs (dysmenorrhea, dyspareunia, pelvic pain, pelvic tenderness, pelvic induration); change in bone mineral density (BMD), hypoestrogenic symptoms, bleeding, and weight.Result(s)The depot medroxyprogesterone acetate given SC was statistically equivalent to leuprolide in reducing four of five endometriosis symptoms or signs at the end of treatment (month 6) and in reducing all five symptoms after 12 months' follow-up (month 18). Patients in the DMPA-SC 104 group showed significantly less BMD loss than did leuprolide patients at month 6, with scores returning to baseline at 12 months' follow-up. No statistically significant differences in median weight changes were observed between groups. Compared with leuprolide, DMPA-SC 104 was associated with fewer hypoestrogenic symptoms but more irregular bleeding.Conclusion(s)Efficacy of DMPA-SC 104 was equivalent to that of leuprolide for reducing endometriosis-associated pain, with less impact on BMD and fewer hypoestrogenic side effects but more bleeding.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Leuprolide Medroxyprogesterone Acetate Pain Pain Palliative Care Adult Bone Density Bone Density Delayed-Action Preparations Endometriosis Endometriosis Estrogens Estrogens Female Flushing Flushing Humans Injections, Subcutaneous Leuprolide

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