Gonadotropin-releasing hormone antagonist (linzagolix): a new therapy for uterine adenomyosis

Donnez O, Olivier Donnez, Donnez J, Jacques Donnez
Fertility and sterility · 2020 · vol. 114(3) , pp. 640–645 · doi:10.1016/j.fertnstert.2020.04.017 · PMID:32507315 · W3033691887
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Linzagolix, a gonadotropin-releasing hormone antagonist, has been investigated as a new therapeutic option for uterine adenomyosis.

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Abstract

OBJECTIVE: To compare the efficacy of a selective progesterone receptor modulator, ulipristal acetate, and a gonadotropin-releasing hormone antagonist, linzagolix, in a case of severe uterine adenomyosis. DESIGN: Case report. SETTING: Private clinic and infertility research unit. PATIENT: One patient born in 1981 who presented because of heavy menstrual bleeding, pelvic pain, and dysmenorrhea due to diffuse and disseminated uterine adenomyosis confirmed by magnetic resonance imaging (MRI). INTERVENTION: The patient received a first treatment of 5 mg UPA daily for one course of 3 months. This therapy was discontinued because MRI revealed a worsened aspect. One year later, a once-daily dose of 200 mg linzagolix administered orally was initiated for 3 months, followed by another 3-month course of 100 mg once daily. MAIN OUTCOME MEASURES: Clinical symptoms and MRI aspect. RESULTS: During treatment with UPA, the symptoms (pelvic pain, dysmenorrhea, bulk symptoms) worsened and MRI revealed aggravation of the adenomyotic lesions. During the 12-week course of once-daily 200 mg linzagolix, the patient remained in amenorrhea and noted a very significant improvement in symptoms. On MRI, the uterine volume had fallen from 875 cm3 to 290 cm3, and the adenomyotic lesions had significantly regressed. During the 100-mg linzagolix course (weeks 13-24), the patient reported continued alleviation of her symptoms. CONCLUSION: To our knowledge, this is the first reported use of linzagolix, a new oral gonadotropin-releasing hormone antagonist that significantly reduced lesion size and improved quality of life in a patient with severe adenomyosis, who was previously nonresponsive to treatment with a selective progesterone receptor modulator, ulipristal acetate.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Gonadotropin-Releasing Hormone Hormone Antagonists Norpregnadienes Uterus Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adult Adult Disease Progression Disease Progression Drug Substitution Drug Substitution Female Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone

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 ]

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