The Effectiveness of "Add-Back" Treatment to Endometriosis:A Meta Analysis

Objective:To compare the effectiveness of Add-back treatment and to endometriosis (EMT) to GnRH-a treatment alone.Methods:The RCT assessing the add-back treatment to EMT were searched from Cochrane library,Medline database,Embase,CNKI and Wanfang database.The meta analysis was analyzed by RevMan V5.0 software.Results:Eight RCT (n=292) were included.There were significant difference between add-back trratment and GnRH-a treatment alone in bone mineral density of lumber spine after treatment weight mean difference(WMD) -0.05(95%CI -0.06 to -0.04),and after 24 months treatment WMD -0.03(95%CI -0.05 to -0.01).But the BMD of femoral neck between two groups had no statistical significance.The WMD for kupperman index after treatment that assessed the efficacy of add-back treatment was -5.13 (95%CI -5.77 to -4.48).The add-back treatment did not appear to reduce the efficacy of GnRH-a alone in dysmenorrheal score and dyspareunia score.Conclusions:The add-back treatment based on GnRH-a dose not reduce efficacy in the management of endometriosis syndrome.add-back treatment also reduces side effects of GnRH-a alone in osteoporosis and menopausal syndrome.