The effect of add-back treatment with tibolone (Livial) on patients treated with the gonadotropin-releasing hormone agonist triptorelin (Decapeptyl)

Lindsay PC, Peter Lindsay, P C Lindsay, Shaw RW, Robert W. Shaw, R W Shaw, Herjan J.T. Coelingh Bennink, Bennink HJ, H J Bennink, P Kicovic, P. M. Kicovic, Kicovic P
Fertility and Sterility · 1996 · vol. 65(2) , pp. 342–348 · doi:10.1016/s0015-0282(16)58096-0 · PMID:8566259 · W1591340500
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This study investigated the efficacy of tibolone add-back therapy in women undergoing treatment with the GnRH agonist triptorelin for endometriosis.

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Abstract

ObjectiveTo assess whether tibolone can prevent the bone loss and symptomatic side effects normally associated with GnRH agonist (GnRH-a) use and whether tibolone modifies the effect of GnRH-a on endometriosis.DesignProspective, double-blind, placebo-controlled, group comparative study.SettingGynecological research unit in a London teaching hospital.PatientsTwenty-nine patients with endometriosis and two with fibroids.InterventionsSix months of treatment with 3.75 mg/mo IM triptorelin combined with daily tablets of either placebo or 2.5 mg tibolone.Main outcome measuresDaily symptom diary for hot flushes and bleeding episodes, laparoscopic scoring of endometriosis, endocrine and biochemical changes, and bone mineral density scans.ResultsLumbar spine bone mineral density decreased significantly from baseline in the placebo group (-5.1%) but not in the tibolone group (-1.1%). The frequency of hot flushes and sweating episodes was reduced significantly by tibolone. There was no difference between the two treatment groups with regard to the endometriosis scores.ConclusionsThe addition of tibolone to GnRH-a treatment reduces the bone loss and vasomotor symptoms that normally occur with GnRH-a, thus making long-term treatment with GnRH-a safer and more acceptable. It does not negate the therapeutic effect of GnRH-a on endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Anabolic Agents Bone Density Endometriosis Leiomyoma Luteolytic Agents Norpregnenes Triptorelin Pamoate Uterine Neoplasms Adult Anabolic Agents Bone Density Double-Blind Method Drug Interactions Endometriosis Female Humans Leiomyoma Luteolytic Agents Luteolytic Agents Norpregnenes

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