Two-step gonadotropin-releasing hormone agonist treatment of uterine leiomyomas: Standard-dose therapy followed by reduced-dose therapy

• Published in: American journal of obstetrics and gynecology Vol. 175; no. 5; pp. 1208 - 1216
• Main Authors: Broekmans, Frank J., Hompes, Peter G.A., Heitbrink, Martin A., Netelenbos, Coen C., Roos, Jan C., Falke, Theo M., Schoemaker, Joop
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.11.1996; Elsevier
• Subjects: Adult; Antineoplastic Agents, Hormonal - administration & dosage; Biological and medical sciences; Bone Density; bone mineral density; dose study; Female; Follicle Stimulating Hormone - blood; gonadotropin-releasing hormone agonist; Hormones. Endocrine system; Humans; Leiomyoma - drug therapy; Leiomyoma - metabolism; Leiomyoma - pathology; leiomyomas; Luteinizing Hormone - blood; Medical sciences; Pharmacology. Drug treatments; Triptorelin; Triptorelin Pamoate - administration & dosage; Uterine Neoplasms - drug therapy; Uterine Neoplasms - metabolism; Uterine Neoplasms - pathology; Triptorelin; dose study; bone mineral density; gonadotropin-releasing hormone agonist; leiomyomas; Human; Leiomyoma; Agonist; Gonadotropin RH; Long term; Female genital diseases; Chemotherapy; Treatment; Surveillance; Uterus; Dual energy absorptiometry; Uterine diseases; Female; Benign neoplasm; Effective dose
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(96)70030-3

OBJECTIVE: Gonadotropin-releasing hormone agonist-induced partial pituitary suppression with low-grade estrogen production may be useful in long-term treatment of uterine leiomyomas. STUDY DESIGN: Twenty-seven women with uterine leiomyomas were treated with a standard dose of triptorelin for 8 weeks. Patients were then randomized to use 100, 20, or 5 μg of triptorelin until week 26. Uterine and myoma size, pituitary-ovarian function, bone metabolism, and bone mineral density were monitored. RESULTS: During standard treatment uterine size was reduced to 67.1% of baseline. During randomized treatment uterine size was further reduced to 57.8% of baseline. There were no differences in overall volume reduction among the groups. Luteinizing hormone and estradiol levels were restored in a dose-dependent way. Bone mineral density decreased significantly in the highest-dose group at week 26. CONCLUSIONS: This study shows that the beneficial effects of initial high-dose agonist treatment on uterine leiomyomas can be preserved by continued low-dose treatment. Bone mineral density does not seem to change during reduced-dose agonist treatment. (Am J Obstet Gynecol 1996;175:1208-16.)