Estradiol/nomegestrol acetate as a first-line and rescue therapy for the treatment of ovarian and deep infiltrating endometriosis

Abstract

Purpose

Estradiol valerate/nomegestrol acetate (E2V/NOMAC) is a new combined oral contraceptive with a good tolerability profile and low drop-out rates, which was shown to improve menstrual-related symptoms. This study aims to evaluate its effectiveness in the control of symptoms and progression of disease in women with ovarian endomestriomas and deep infiltrating endometriosis (DIE).

Methods

This was a retrospective cohort study on 39 women with pelvic endometriosis treated with E2V/NOMAC. We assessed for each patient, at the beginning of treatment and after 6 months, the painful symptoms, through a global VAS (Visual Analogue Scale) index and the size of the greatest ovarian and/or deep infiltrating endometriotic lesions.

Results

After 6 months of treatment, a significant reduction was observed for the global VAS score for pain symptoms and for the mean size of ovarian endometriomas, whereas DIE lesions did not present significant changes in mean size.

Conclusions

E2/NOMAC was effective in reducing pain symptoms associated with pelvic endometriosis and the size of ovarian endometriomas, whereas DIE lesions remained stable. This therapy could provide good results in the control of symptoms and disease progression in women with pelvic endometriosis.

摘要

目的：戊酸雌二醇/醋酸诺美孕酮 (E2V/NOMAC) 是一种新型复方口服避孕药, 具有良好的耐受性和低脱落率, 已被证明可改善月经相关症状。本研究旨在评估其在控制患有卵巢子宫内膜异位症和深部浸润性子宫内膜异位症 (DIE) 的女性的症状和疾病进展方面的有效性。

方法：这是一项针对 39 名接受 E2V/NOMAC 治疗的盆腔子宫内膜异位症女性的回顾性队列研究。我们在治疗开始时和 6 个月后, 通过总体 VAS（视觉模拟量表）指数和最大卵巢和/或深部浸润性子宫内膜异位病变的大小评估了每位患者的疼痛症状。

结果：治疗 6 个月后, 观察到疼痛症状的整体 VAS 评分和卵巢子宫内膜异位症的平均大小显着降低, 而 DIE 病变的平均大小没有显著变化。

结论：E2/NOMAC 可有效减轻与盆腔子宫内膜异位症相关的疼痛症状和卵巢子宫内膜异位症的大小, 而 DIE 病变保持稳定。这种疗法可以在控制盆腔子宫内膜异位症女性的症状和疾病进展方面取得良好的效果。

Keywords:

• Endometriosis
• estradiol valerate/nomegestrol acetate
• ultrasonography

Ethics approval

The study was conducted in accordance with the 1964 Declaration of Helsinki. Since this was a retrospective study on a treatment with estrogen-progestins which are considered first-line treatment for endometriosis and being therefore all the procedures performed as part of the routine care, no ethical committee approval was needed.

Consent to participate and to publish

Informed consent was obtained from all individual participants included in the study. All patients gave their consent to the anonymous use and publication of their data for scientific purposes.

Disclosure statement

All Authors declare that there is no conflict of interests regarding the publication of this article.

Data availability statement

Due to their sensitive nature, the data that support the findings of this study are available on request from the corresponding author (N.B.).