A progestin isn't a progestin: dienogest for endometriosis as a blueprint for future research - Review as a contribution for discussion

M. Öettel, Michael Oettel, Oettel M, Hans Joachim Zentel, Zentel HJ, Nickisch K, Klaus Nickisch
Hormone molecular biology and clinical investigation · 2020 · vol. 42(2) , pp. 133–142 · doi:10.1515/hmbci-2020-0013 · PMID:32663169 · W3043694492
Review OA: closed CC0 ⤵ 5 in-corpus citations
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This review discusses dienogest's unique progestin profile and mechanisms of action, proposing future research into compounds with combined progestogenic, anti-inflammatory, anti-fibrotic, or pro-apoptotic activities for endometriosis.

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Abstract

The different etiopathogenetic mechanisms and the diversity of clinical features of endometriosis has not yet allowed to identify a causal pharmacological monotherapy satisfying the unresolved medical needs in this important female disease. Therefore, despite the search for new therapeutic principles for the indication, the strategy of gradual optimization of established therapeutic principles should not be disregarded.In the case of progestins, the fact that each compound has its own, specific profile may allow to study the therapeutic relevance of the various signal cascades influenced by their receptors.Using the example of the progestin dienogest, the different genomic and non-genomic mechanisms of action are discussed. It is pharmacodynamic profile is unique compared to other progestins.In light of the emerging multitude of pathomechanisms in endometriosis, a monotherapy may not be possible, and then the search for broad spectrum compounds or combination therapies with dual or multiple mode of action in a clinically relevant dose range might be considered. The progestogenic action may greatly benefit from, by way of example, additional anti-inflammatory and/or anti-fibrotic and/or pro-apoptotic activities. Such a strategy could lead to new drug classes.

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Condition tags

endometriosis

MeSH descriptors

Contraceptives, Oral, Hormonal Endometriosis Nandrolone Progestins Clinical Decision-Making Clinical Decision-Making Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Disease Management Disease Management Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans

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 ]

References (70)

Cited by (6)

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License: CC0 · commercial use OK