Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis

Luigi Della Corte, Fabio Barra, Antonio Mercorio, Giulio Evangelisti, Agnese Maria Chiara Rapisarda, Simone Ferrero, Giuseppe Bifulco, Pierluigi Giampaolino
Expert opinion on drug metabolism & toxicology · 2020 · vol. 16(9) , pp. 759–768 · doi:10.1080/17425255.2020.1789591 · PMID:32597340 · W3037757262
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This review examines the safety and tolerability of gonadotropin-releasing hormone analogs for endometriosis, focusing on add-back therapies to mitigate hypoestrogenic side effects.

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Abstract

INTRODUCTION: The second-line treatment of endometriosis-related pain symptoms includes injectable depot formulations of gonadotropin-releasing hormone analogs (GnRH-as). These drugs improve the symptomatology by inducing a hypoestrogenic status and a consequent regression of endometriotic implants. However, GnRH-a may cause a not negligible rate of adverse events, in particular vasomotor symptoms and bone mineral density loss, that may limit patients' adherence and safety on long-term treatment. Several strategies have been suggested to improve the compliance to treatment. AREAS COVERED: This narrative review aims to give an overview of the safety and tolerability of GnRH-a therapy and to present the different options of steroidal and non-steroidal add-back therapies in order to reduce the hypoestrogenic side effects. EXPERT OPINION: Side effects of long term GnRH-a treatment are particularly relevant. Although it has been known the efficacy of GnRH-as for treating endometriosis-associated pain, the best schedules of therapy in terms of duration and dosages are still to be defined. The ideal treatment schedule of GnRH-a is still a matter of debate as to the optimal add-back combination.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Gonadotropin-Releasing Hormone Medication Adherence Animals Bone Density Bone Density Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Steroids Steroids Vasomotor System Vasomotor System

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (22)

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License: CC0 · commercial use OK