Dienogest and the Risk of Endometriosis Recurrence Following Surgery: A Systematic Review and Meta-analysis

Andrew Zakhari, Zakhari A, Darl Edwards, D.L. Edwards, Edwards D, Michelle Ryu, Ryu M, John J Matelski, John Matelski, Matelski JJ, Olga Bougie, Bougie O, Ally Murji
Journal of Minimally Invasive Gynecology · 2020 · vol. 27(7) , pp. 1503–1510 · doi:10.1016/j.jmig.2020.05.007 · PMID:32428571 · W3025366094
review OA: closed CC0 ⤵ 55 in-corpus citations
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This systematic review and meta-analysis assessed the impact of dienogest on endometriosis recurrence rates after surgical intervention.

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Abstract

Study objectiveTo determine whether dienogest therapy after endometriosis surgery reduces the risk of endometriosis recurrence compared with expectant management.Data sourcesOvid MEDLINE, Ovid EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, clinicaltrials.gov, and International Standard Randomized Controlled Trial Number Registry were searched from inception to March 2019 for observational and randomized controlled trials.Methods of study selectionThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Medical Subject Heading terms and keywords such as "dienogest," "endometriosis," and "recurrence" were used to identify relevant studies.Tabulation, integration, and resultsThe search yielded 328 studies, 10 of which were eligible for inclusion, representing 1184 patients treated with dienogest and 846 expectantly managed controls. Among these studies, 9 looked exclusively at endometrioma recurrence, whereas 1 used reappearance of symptoms as evidence of disease recurrence. Data on both incidence of and time to recurrence of endometriosis were extracted. The incidence rate of endometriosis recurrence in patients treated with dienogest was 2 per 100 women over a mean follow-up of 29 months (95% confidence interval [CI], 1.43-3.11) versus 29 per 100 women managed expectantly over a mean follow-up of 36 months (95% CI, 25.66-31.74). The likelihood of recurrence was significantly reduced with postoperative dienogest (log odds -1.96, CI, -2.53 to -1.38, p <.001).ConclusionPatients receiving dienogest after conservative surgery for endometriosis had significantly lower risk of postoperative disease recurrence than those who were expectantly managed.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Nandrolone Combined Modality Therapy Endometriosis Endometriosis Female Humans Incidence Nandrolone Nandrolone Observational Studies as Topic Observational Studies as Topic Randomized Controlled Trials as Topic Randomized Controlled Trials as Topic Recurrence Risk Factors Secondary Prevention Secondary Prevention

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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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