A randomized study comparing the side effects and hormonal status of triptorelin and leuprorelin following conservative laparoscopic surgery for ovarian endometriosis in Chinese women

Abstract Objectives Different gonadotropin-releasing-hormone agonist (GnRH-a) formulations with different potency and associated side effects, therefore, different compliance and persistence of therapy. This study was to evaluate the difference of hormonal profile and side effects due to hypoestroge...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2014-12, Vol.183, p.164-168
Main Authors: Li, Zheng, Zhang, Hong yuan, Zhu, Ying jun, Hu, Yuan jing, Qu, Peng peng
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biomarkers - blood
Chemotherapy, Adjuvant
China
Drug Administration Schedule
Endometriosis - blood
Endometriosis - drug therapy
Endometriosis - surgery
Female
Follow-Up Studies
Gonadotropin-releasing hormone
Hormone Antagonists - adverse effects
Hormone Antagonists - therapeutic use
Hormones - blood
Humans
Laparoscopy
Leuprolide - adverse effects
Leuprolide - therapeutic use
Leuprorelin
Middle Aged
Obstetrics and Gynecology
Ovarian Diseases - blood
Ovarian Diseases - drug therapy
Ovarian Diseases - surgery
Ovary endometriosis
Single-Blind Method
Treatment Outcome
Triptorelin
Triptorelin Pamoate - adverse effects
Triptorelin Pamoate - therapeutic use
Young Adult
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Summary:Abstract Objectives Different gonadotropin-releasing-hormone agonist (GnRH-a) formulations with different potency and associated side effects, therefore, different compliance and persistence of therapy. This study was to evaluate the difference of hormonal profile and side effects due to hypoestrogenic status after treatment of leuprorelin and triptorelin in Chinese women with ovarian endometrioma after conservative surgical treatment. Study design A total of 302 women underwent laparoscopic excision of ovarian endometriomas with rASRM III and IV were enrolled in the study.Subjects were randomized into two groups with use of a random table. Twenty two patients dropped out during the study. Thus 142 patients had three doses of i.m. leuprorelin (group A) and 138 patients had three doses of i.m. triptorelin(group B) at 4 weeks intervals after surgical treatment. Menopausal symptoms were evalutaed using a questionnaire and serum sex hormonal levels were also measured during the follow-up. Results At week 4 after the treatment, most of the patients in leuprorelin group have no obvious side effects. After 9 weeks, bone pain, hot flashes and sweating, and irregular bleeding were the main side effects and showed no difference between the groups. Anxiety, depression, vaginal dryness, headache, and acne rates were all significantly higher in triptorelin group than in leuprorelin group. A significant difference in FSH ( p = 0.003), LH ( p = 0.026) and E2 ( p = 0.002) levels between the groups were observed after 21 days of the GnRHa treatment. The FSH ( p = 0.021) and E2 ( p = 0.033) levels remained higher in the leuprorelin group than the triptorelin group after six weeks of treatment, but the difference of LH( p = 0.917) level was no longer discernible. Conclusion Leuprorelin in down-regulating the pituitary-ovarian function was more moderate, and the hormonal levels decrease progressively and gradually, therefore, with lower rate of menopausal symptoms. Leuprorelin acetate maybe better tolerated than triptorelin.
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2014.10.022