Use of depot GnRH antagonist (degarelix) in the treatment of endometriosis recurrence. A controlled trial

Abstract

In order to evaluate the effectiveness of a depot GnRH antagonist (Degarelix) in the patients with recurrence of severe endometriosis we performed a randomized controlled trial between depot GnRH antagonist versus GnRH agonist. A randomized controlled trial. Women with endometriosis recurrence referred to us from November 2011 to April 2012 were eligible for inclusion in the study. Inclusion criteria were: severe endometriosis previously treated with surgery and at least one year of progestin treatment before recurrence, A total of 40 patients with endometriosis recurrence were randomly assigned to the two arms of the study by a computer generated number sequence. In the experimental group 20 patients were treated Degarelix 80 mg monthly for three months (Firmagon 80 mg, Ferring, Denmark), whereas the control group, 20 patients, were treated with Leuprolide acetate 3,75 monthly for three months. Patients included in the study were followed up for six months: they underwent pelvic ultrasound and CA-125 evaluation every three months. To evaluate the pain intensity a visual analog scale (VAS) was administered to the women. Statistical analysis was performed using for qualitative variables Fisher exact test and for quantitative variables Student t test. The women treated with depot GnRH antagonist showed higher reduction in the pain symptom than in the control group, as the VAS data evidenced (P<0.01). Furthermore, the CA-125 plasmatic values were significantly lower in the study group than in controls (P<0.01). After the follow-up of these patients (six months) the study group showed a statistical significant lower rate of recurrence rate than in controls (5% vs 35%; P<0.05). The depot GnRH antagonist degarelix is a promising treatment in women with endometriosis recurrence.