A cohort study of the efficacy of the dienogest and the gonadotropin-releasing hormone agonist in women with adenomyosis and dysmenorrhea

Abstract

Purpose

To study the efficacy and safety of the dienogest and the gonadotropin-releasing hormone agonist (GnRH-a) in symptomatic females with uterine adenomyosis.

Methods

A total of 127 patients with adenomyosis with a chief complaint of dysmenorrhea were recruited. The first group received 2 mg of dienogest (DNG) daily, whereas the second group received goserelin acetate (GS) (3.6 mg/4 weeks) for 12 weeks. Outpatient follow-up was undertaken after 12 weeks.

Results

Among 127 women, 56/63 (88.9%) patients completed the treatment in the DNG group, whereas 62/64 (96.9%) patients completed the treatment in the GS group. A significant decrease in dysmenorrhea symptoms as measured by the visual analog scale (VAS) and Carcinoma antigen125 (CA125) after 12 weeks of treatment was observed in both groups (p < .001). The hemoglobin of anemic patients did not significantly improve after 12 weeks of treatment (p＝0.21) and the uterine volume slightly increased without statistical significance (p＝0.10) in the DNG group. Simultaneously, The hemoglobin of anemic patients significantly improved (p < .001) and the uterine volume significantly decreased (p < .001) in the GS group.

Conclusions

Dienogest effectively alleviates the symptoms of dysmenorrhea in patients with adenomyosis, but it cannot improve the anemia or reduce the size of the uterus. GnRH-a is more effective in improving anemia and reducing the uterine volume in patients with adenomyosis. TRIAL REGISTRATION: ChiCTR1900024958

子宫腺肌病和痛经女性患者使用地诺孕素和促性腺激素释放激素激动剂疗效的队列研究 摘要

目的：研究地诺孕素和促性腺激素释放激素激动剂（gonadotropin-releasing hormone agonist, GnRH-a）治疗有症状的子宫腺肌病女性患者的疗效和安全性。

方法：共招募127例以痛经为主诉的子宫腺肌病患者。第一组每天服用2毫克地诺孕素（DNG）, 第二组服用醋酸戈舍瑞林（GS）（3.6毫克/4周）, 共用12周。12周后进行门诊随访。

结果：在127名女性中, DNG组56/63（88.9%）患者完成了治疗, GS组62/64（96.9%）患者完成了治疗。治疗12周后, 通过视觉模拟量表（visual analog scale, VAS）和CA125测量, 两组患者的痛经症状均显著减轻（p<0.001）。DNG组贫血患者的血红蛋白在治疗12周后没有显著改善（p＝0.21）, 子宫体积略有增加, 但不显著（p＝0.10）。GS组贫血患者的血红蛋白显著改善（p<0.001）, 子宫体积显著减少（p<0.001）。

结论：地诺孕素能有效缓解子宫腺肌病患者的痛经症状, 但不能改善贫血或缩小子宫大小。GnRH-a对改善子宫腺肌病患者贫血和减少子宫体积更有效。实验注册：ChiCTR1900024958。

Keywords:

• Adenomyosis
• dienogest
• GnRH-a

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Nature Science Foundation of China [81771552] and the Technology Development Plan of Shandong Province [2019GSF108071].