Abstract
Dienogest is a progestogen that combines the pharmacological properties of 19-norprogestins and progesterone derivatives. Dienogest has a potent effect on endometrial tissue, producing antiproliferative effects on endometriotic cells, as well as anti-inflammatory and antiangiogenic actions. Dienogest has been systematically investigated for the treatment of endometriosis through comprehensive study programs in Europe and Japan. Clinical experience of dienogest at 2 mg daily orally demonstrates that it significantly reduces endometriotic lesions and provides effective pain relief comparable to the current efficacy standard, combined with a favorable safety and tolerability profile that allows long-term use. Study data over 15 months show sustained pain relief and low incidences of treatment-related adverse events. As with other progestogens, spotting or breakthrough bleeds are common, but usually lessen during long-term treatment. Dienogest does not produce antiestrogenic side effects, such as bone mass loss. This article reviews the evidence for the use of dienogest in endometriosis.
Financial & competing interests disclosure
Serving in various university research units, Alfred O Mueck has received funding for research and educational activities from manufacturers developing sexual steroids for use in hormone-replacement therapy, hormonal contraceptives and endometriosis. He has been a principal investigator and/or co-investigator of trials in this field sponsored by pharmaceutical companies. Financial support to conduct this research was given by Novartis, Organon/Essex, Schering Plough, Novo Nordisk, Bayer Schering Pharma AG, Jenapharm, Wyeth, Merck and Besins/Kade. Alfred Mueck has received from these, and also Solvay, Procter and Gamble and Eli Lilly, consultancy fees for advice in special projects and/or to speak publicly about benefits and risks using the products of those companies. He serves on the board of several societies and journals covering this field of treatment using sexual steroids. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Editorial support for this article was provided by PAREXEL MMS, supported by a grant from Bayer Schering Pharma AG.