Quantitative Assessment of Elagolix Enzyme-Transporter Interplay and Drug –Drug Interactions Using Physiologically Based Pharmacokinetic Modeling

ConclusionsA PBPK model of elagolix was developed, verified, and applied to characterize the disposition interplay between CYP3A4 and OATP1B1, and to predict the DDI potential of elagolix as a perpetrator under dosing conditions that were not tested clinically. PBPK model-based predictions were used to support labeling language for DDI recommendations of elagolix.
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research

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This article addresses the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of endometriosis in the adolescent.
Source: Journal of Pediatric and Adolescent Gynecology - Category: OBGYN Authors: Source Type: research
CONCLUSIONS: TR-HIFU therapy for posterior DIE is feasible. It could be an interesting minimally invasive alternative to surgery for the treatment of rectosigmoid endometriosis if its efficacy and safety is confirmed. This article is protected by copyright. All rights reserved. PMID: 31788875 [PubMed - as supplied by publisher]
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
AbstractThe clinical pharmacology of elagolix was extensively evaluated in clinical studies in healthy subjects and in women with endometriosis. Elagolix pharmacokinetics (PK) show significant population variability, however they are minimally affected by patients ’ baseline characteristics and demographics, except for clinically relevant extrinsic and intrinsic factors such as coadministrated strong organic anion transporting polypeptide (OATP) 1B1 inhibitors and severe hepatic impairment, which are contraindications for the use of elagolix. These studies enabled a comprehensive understanding of elagolix mechan...
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: Australian law currently requires legal medicinal cannabis use to follow specific, regulated pathways that limit prescription by this method; however, self-reported illicit use of cannabis remains relatively common in Australian women with endometriosis. Women report good efficacy of cannabis in reducing pain and other symptoms, with few adverse effects reported. Further clinical research is warranted to determine the effectiveness of cannabis in managing endometriosis symptoms. In locations where medicinal cannabis is more accessible, there remains a paucity of evidence for its clinical efficacy with endometri...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
ConclusionSurgical RCTs have always been difficult to undertake, yet there are 16 RCTs in the area of endometriosis-associated pain. Ethical considerations, the equipoise of surgeons and participants and follow-up duration are all important parameters in establishing RCTs. We must also be willing to accept and adopt the evidence when it does demonstrate a particular outcome – such as the fact that surgical uterosacral nerve disruption does not improve pain, or that disc excision does not substantially reduce complications compared to segmental resection for bowel disease as prior non-randomized studies suggested. If ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
We have demonstrated that women with endometriosis-associated pain experience a high prevalence of pain imagery and coping imagery and we believe this may have therapeutic implications for pain management of this common, debilitating disease.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Short communication Source Type: research
To report on randomized trials that examine the surgical treatment of endometriosis associated pelvic pain and highlight their strengths and weaknesses.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Source Type: research
Conclusions: This is the first comparison of patient and practitioner perceptions of endometriosis in primary healthcare. Models of multi-disciplinary, collaborative care need to be developed and evaluated against consumer-informed measures of women's wellbeing, quality of life and satisfaction with symptom management and health care. PMID: 31691598 [PubMed - as supplied by publisher]
Source: Journal of Psychosomatic Obstetrics and Gynaecology - Category: OBGYN Tags: J Psychosom Obstet Gynaecol Source Type: research
AbstractPostmenopausal endometriosis is an important clinical entity which is likely under-recognized and in which the Radiologist can play a valuable role. In this review, we describe the clinical presentation and management of postmenopausal endometriosis, appraising the literature and providing case examples. Persons with postmenopausal endometriosis may present with symptoms including pelvic pain or dyschezia, but endometriosis may also be an asymptomatic, incidental finding. Women may or may not have a prior history of endometriosis or a history of symptoms consistent with it. Therapies and conditions which increase e...
Source: Abdominal Imaging - Category: Radiology Source Type: research
This article provides a comprehensive and practical approach to the clinical diagnosis of EAP, which can subsequently facilitate prompt and directed treatment. The key components of the history, physical examination, and high-quality imaging to evaluate suspected EAP and related pain conditions are presented.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Special Article Source Type: research
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