Clinical, endocrine, and metabolic effects of two doses of gestrinone in treatment of pelvic endometriosis

• Published in: American journal of obstetrics and gynecology Vol. 176; no. 2; pp. 387 - 394
• Main Authors: Dawood, M.Yusoff, Obasiolu, Charles W., Ramos, Josefina, Khan-Dawood, Firyal S.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.02.1997; Elsevier
• Subjects: Adult; Biological and medical sciences; bone mass; Double-Blind Method; Drug Administration Schedule; dysmenorrhea; endometriosis; Endometriosis - blood; Endometriosis - drug therapy; Female; Follicle Stimulating Hormone - blood; gestrinone; Gestrinone - administration & dosage; Gestrinone - pharmacology; Hormones. Endocrine system; Humans; Luteinizing Hormone - blood; Medical sciences; pelvic pain; Pelvis; Pharmacology. Drug treatments; Progesterone Congeners - administration & dosage; Progesterone Congeners - pharmacology; Prospective Studies; Sex Hormone-Binding Globulin - metabolism; endometriosis; bone mass; pelvic pain; gestrinone; dysmenorrhea; Human; Endometriosis; Metabolism; Female genital diseases; Progestagen; Chemotherapy; Treatment; Pelvic cavity; Number; Gestrinone; Abdominal disease; Uterine diseases; Female; Effective dose; Hormonal investigation
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(97)70504-0

OBJECTIVE: Our purpose was to determine and compare the efficacy and hormonal and metabolic effects of 1.25 mg with 2.5 mg of gestrinone given twice a week in the treatment of mild and moderate pelvic endometriosis. STUDY DESIGN: A phase II, prospective, randomized, double-blind study involving 11 patients given gestrinone 1.25 mg (five patients) or 2.5 mg (six patients) orally twice a week for 24 weeks was performed. Revised American Fertility Society scores were determined by laparoscopy before and at the end of treatment. Serum hormone (free thyroxine, free testosterone, estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone), sex hormone binding globulin, and lipid concentrations were measured before, throughout, and for 6 months after treatment. Quantitated computerized tomography of thoracic 12 through lumbar 4 vertebral bodies were determined before, at the end of, and 6 months after treatment. RESULTS: Gestrinone 2.5 mg significantly reduced the endometriosis implant score from 10.3 ± 2.8 to 3.8 ± 0.8 ( p = 0.05). Both doses significantly reduced serum progesterone and sex hormone binding globulin levels. Estradiol, free testosterone, free thyroxine, follicle-stimulating hormone, and luteinizing hormone levels were not significantly affected. Spinal bone increased significantly by 7.1% with 2.5 mg but lost significantly by 7.1% with 1.25 mg gestrinone; these changes had not reversed completely 6 months after stopping treatment. CONCLUSION: In mild to moderate pelvic endometriosis 2.5 mg of gestrinone twice a week was more effective and had a more positive effect on bone mass than did 1.25 mg of gestrinone. (Am J Obstet Gynecol 1997;176:387-94.)