New treatment strategies and emerging drugs in endometriosis

Isabelle StreuliUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Department of Obstetrics Gynaecology and Reproductive Medicine, Paris, France;Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Immunology Laboratory EA1833, Paris, France;Service d'Obstétrique, Gynécologie et Médecine de la Reproduction II APHP - Hôpital Cochin 53, Avenue de l'Observatoire 75014 Paris, France [email protected]

, MD,

Dominique de ZieglerUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Department of Obstetrics Gynaecology and Reproductive Medicine, Paris, France

, MD,

Bruno BorgheseUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Department of Obstetrics Gynaecology and Reproductive Medicine, Paris, France

, MD PhD,

Pietro SantulliUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Department of Obstetrics Gynaecology and Reproductive Medicine, Paris, France;Université Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Immunology Laboratory EA1833, Paris, France

, MD,

Frédéric BatteuxUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Immunology Laboratory EA1833, Paris, France

, MD PhD &

Charles ChapronUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de médecine – Assistance Publique des Hôpitaux de Paris, CHU Cochin, Department of Obstetrics Gynaecology and Reproductive Medicine, Paris, France;Cochin Institute, CNRS UMR 8104, INSERM U1016, Paris, France;Service de Gynécologie Obstêtrique 11, Hôpital Cochin - St Vincent de Paul, 82 Bd Denfert Rochereau, 75014, Paris, France

, MD

Abstract

Introduction: Endometriosis, histologically defined as the presence of endometrium-like tissue – glands and stroma – that develops outside of the uterine cavity, is still an enigmatic disease responsible for pelvic pain and infertility. The current treatments of endometriosis are surgery and hormonal therapies that act by suppressing ovulation and/or directly on steroid receptors located in endometriotic lesions.

Areas covered: New hormonal and non-hormonal therapies are being developed for the treatment of endometriosis-related pain. The authors review the state of advancement and the results of novel treatments studied in registered trials (www.ClinicalTrials.gov). Cellular signaling pathways activated in endometriotic cells, which constitute potential targets for future treatments, are also described.

Expert opinion: Therapeutic research efforts should focus on identifying and testing substances capable of acting locally on the lesions themselves, without interfering with ovulation, in order to be efficacious on both pain symptoms and infertility.

Keywords::

Acknowledgments

The authors thank MC Streuli for reviewing the English language of the manuscript.

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