Elagolix sodium for the treatment of women with moderate to severe endometriosis-associated pain.

Elagolix sodium for the treatment of women with moderate to severe endometriosis-associated pain. Drugs Today (Barc). 2019 Apr;55(4):237-246 Authors: Barra F, Scala C, Ferrero S Abstract First-line medical therapies for treating pain associated with endometriosis mainly consist in combined oral contraceptives and progestins. However, some women, having persistence of symptoms, may require further therapeutic options. Among these, gonadotropin-releasing hormone (GnRH) agonists (GnRH-as) have been widely employed in the last 30 years, despite being characterized by an unfavorable safety profile. Currently, new alternative investigational options are being investigated to treat this benign chronic disease. GnRH antagonists (GnRH-ants) are innovative hormonal drugs that do not induce flare-up effects and present also a limited onset of hypoestrogenic symptoms; in fact, their pharmacological mechanism of action, which consists in pure antagonistic activity, differs from that of traditional GnRH-as. In July 2018, the U.S. Food and Drug Administration (FDA) approved elagolix sodium for the management of moderate to severe pain associated with endometriosis, after the drug showed promising efficacy and safety results in previous phase III trials. This monograph aims to provide a complete overview of the pharmacokinetics, clinical efficacy and safety of this GnRH-ant for treat¬ing patients with endometriosis. PMID: 31050692 [PubMed - in process]
Source: Drugs of Today - Category: Drugs & Pharmacology Tags: Drugs Today (Barc) Source Type: research

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Thank you for your letter entitled “Years of unjustified hypoestrogenism, fear, and stress will not improve the management of chronic pelvic pain!” The goal of our manuscript entitled “Clinical diagnosis of endometriosis: a call to action” 1 was to highlight the current unacceptable delay in diagnosis and to encourage a focu s on pain, functioning, and quality of life, with or without a previous surgical diagnosis endometriosis. We agree with your statement “Even minimally invasive surgery is too invasive to manage minimal endometriosis, which is not always progressive and may heal during...
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Letter to the Editors Source Type: research
ConclusionMinimal preoperative factors are associated with nonresponse for women having surgery for endometriosis. The severity of pain experienced by women with endometriosis may be used to predict their response to surgery.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusions and Relevance Cystectomy of ovarian endometriomas has been the first-line treatment for management for many years because it provides improved pain relief, reduces recurrence rates, and was thought to be favorable in in vitro fertilization. However, a growing body of evidence is demonstrating benefit, or at least no harm, in expectant management for asymptomatic patients with small, stable endometriomas. Medical management is often very effective and appropriate first line. When surgical intervention is appropriate, careful ovarian cyst excision with goal of ovarian tissue preservation and treatment of additi...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: CME ARTICLES Source Type: research
ConclusionThere are minimal pre-operative factors that are associated with non-response for women having surgery for endometriosis. The severity of pain experienced by women with endometriosis may be used to predict their response to surgery.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
This study aims to give insight into the optimal management of adolescents with surgically confirmed endometriosis, reviewing symptom control achieved with intra-surgical placement of Levonorgestrel IUD (LngIUS) compared to other hormonal options.
Source: Journal of Pediatric and Adolescent Gynecology - Category: OBGYN Authors: Source Type: research
Publication date: January 2019Source: Journal of Minimally Invasive Gynecology, Volume 26, Issue 1Author(s): Kristin A. Riley, Andrea S. Benton, Timothy A. Deimling, Allen R. Kunselman, Gerald J. HarkinsAbstractStudy ObjectiveTo compare surgical excision and ablation of endometriosis for treatment of chronic pelvic pain.DesignRandomized clinical trial with 12-month follow-up (Canadian Task Force classification I).SettingSingle academic tertiary care hospital.PatientsWomen with minimal to mild endometriosis undergoing laparoscopy.InterventionsExcision or ablation of superficial endometriosis at the time of robot-assisted la...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Semin Reprod Med 2018; 36: 116-122 DOI: 10.1055/s-0038-1676088Dysmenorrhea and noncyclic pelvic pain (chronic pelvic pain) are common in adolescents. The evaluation of teens with dysmenorrhea or chronic pelvic pain is aimed to diagnose possible gynecologic conditions (endometriosis, pelvic inflammatory disease, ovarian cysts, and obstruction of the reproductive tract) and nongynecologic conditions (irritable bowel syndrome, interstitial cystitis, and myofascial pain). The management of chronic pelvic pain in adolescents is often more complex than in adult women because both the adolescent and her parents are counseled and ...
Source: Seminars in Reproductive Medicine - Category: Reproduction Medicine Authors: Tags: Review Article Source Type: research
AbstractEndometriosis is a chronic benign disease that affects women of reproductive age. Medical therapy is often the first line of management for women with endometriosis in order to ameliorate symptoms or to prevent post-surgical disease recurrence. Currently, there are several medical options for the management of patients with endometriosis. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of chronic inflammatory conditions, being efficacious in relieving primary dysmenorrhea. Combined oral contraceptives (COCs) and progestins, available for multiple routes of administration, are effecti...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
Endometriosis management is a permanent controversy. Based on the concept that the disease is chronic and will inevitably recur if a permanent amenorrhea is not obtained, and assuming that surgery may induce severe complications, many investigators have proposed long-term medical management of all patients diagnosed and or suspected to have endometriosis (1). Surgery would be reserved for a failure with medical treatment: persistent pain despite amenorrhea being attained. This “all-medical approach” may also be favored by the patients who have been extensively counseled about surgical complications.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
Authors: Liu SJ, Lv W Abstract Deep infiltrating endometriosis (DIE) is a complex disorder that affects 6% to 12% of all women in the reproductive age. In these cases, treatment is more difficult with possible incomplete pain relief and a considerable possibility of recurrence. Here, the authors report a case of a 41-year-old woman with a history of severe dysmenorrhea, dyspareunia, and chronic pelvic pain because of deep infiltrating pelvic and peritoneal endometriosis, who underwent segmental colorectal resection three years ago for large bowel obstruction due to colonic endometriosis. To ensure complete removal ...
Source: Clinical and Experimental Obstetrics and Gynecology - Category: OBGYN Tags: Clin Exp Obstet Gynecol Source Type: research
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