GnRH agonists and add‐back therapy: is there a perfect combination?

Pickersgill, Andrew

doi:10.1111/j.1471-0528.1998.tb10146.x

Cited by 58 publications

(25 citation statements)

References 170 publications

(378 reference statements)

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“…The addition of progestins (MPA 20 mg/day) at the start of the GnRH agonist treatment induces a reduction in uterine volume compared with analog alone [48]. On the contrary, it seems to be more effective to start the treatment with the analog alone and to add the addback therapy only after 3 months [41]. After this ''window period'' of 3 months, the estro-progestin addition (0.75 mg estropipate daily plus 0.7 mg norethisterone acetate [NETA] sequentially added) is more effective than only progestin coadministration (NETA, 10 mg/day) in terms of leiomyoma size reduction [43,44].…”

Section: Add-back Therapymentioning

confidence: 92%

“…GnRH-a are usually administered in the early follicular phase (day 2-3 of the menstrual cycle). They are used preoperatively for 2 or 3 months in short-term protocols both to reduce fibroid and uterine volume and to control bleeding, whereas long-term protocols (over 6 months) are used in perimenopausal women to induce an iatrogenic climacteric state in the long-term nonsurgical management of symptomatic leiomyomas [41]. This is one of the most important challenges of endocrinological gynecology.…”

Section: Gnrh Agonistsmentioning

confidence: 99%

“…The hypoestrogenism induced by the use of GnRH agonists causes several climacteric-like symptoms such as hot flashes, vaginal dryness, reduced libido, metabolic alterations, cognitive deficits, and, above all, bone loss that varies from 0.8% to 7% after 12 months of GnRH agonist administration [41,[43][44][45][46]. Notwithstanding the metabolic alterations recently studied in women treated with GnRH agonists [47], at the present there is no clear evidence of cardiovascular risk related to GnRH agonist treatment [41,[43][44][45][46].…”

Section: Gnrh Agonistsmentioning

confidence: 99%

“…There are several protocols for analog administration [41]. GnRH-a are usually administered in the early follicular phase (day 2-3 of the menstrual cycle).…”

Section: Gnrh Agonistsmentioning

confidence: 99%

“…For GnRH agonist administration beyond 6 months, it has been postulated that the addition of low doses of steroids (''add-back therapy'') may avoid the adverse effects due to the prolonged hypoestrogenism state without reducing the efficacy of analog alone [41,[43][44][45][46].…”

Section: Gnrh Agonistsmentioning

confidence: 99%

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GnRH analogs for the treatment of symptomatic uterine leiomyomas

et al. 2005

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Uterine leiomyomas are the most frequent benign disease of the female reproductive tract. To date, the standard treatment of uterine leiomyomas is laparotomic/laparoscopic excision in women who want to preserve their fertility, whereas the use of a more extensive surgery, such as hysterectomy, is reserved for disseminated uterine leiomyomatosis, usually in the perimenopausal period. Given the pathogenesis of uterine leiomyomas, it is clear that future treatments for leiomyomas may be medical. At present the only clinically relevant medical treatment of uterine leiomyoma is GnRH agonist administration in depot formulations. In this review, the use of GnRH agonists, with or without ''add-back therapy,'' and antagonists will be assessed.

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Section: Add-back Therapymentioning

confidence: 92%

Section: Gnrh Agonistsmentioning

confidence: 99%

Section: Gnrh Agonistsmentioning

confidence: 99%

“…There are several protocols for analog administration [41]. GnRH-a are usually administered in the early follicular phase (day 2-3 of the menstrual cycle).…”

Section: Gnrh Agonistsmentioning

confidence: 99%

Section: Gnrh Agonistsmentioning

confidence: 99%

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GnRH analogs for the treatment of symptomatic uterine leiomyomas

et al. 2005

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Selective Estrogen Receptor Modulators

Otero²,

C³

2006

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Selective estrogen receptor modulators (SERMs) are now being used as a treatment for breast cancer, osteoporosis and postmenopausal symptoms, as these drugs have features that can act as an estrogen agonist and an antagonist, depending on the target tissue. After tamoxifen, raloxifene, lasofoxifene and bazedoxifene SERMs have been developed and used for treatment. The clinically decisive difference among these drugs (i.e., the key difference) is their endometrial safety. Compared to bisphosphonate drug formulations for osteoporosis, SERMs are to be used primarily in postmenopausal women of younger age and are particularly recommended if there is a family history of invasive breast cancer, as their use greatly reduces the incidence of this type of cancer in women. Among the above mentioned SERMs, raloxifene has been widely used in prevention and treatment of postmenopausal osteoporosis and vertebral compression fractures, and clinical studies are now underway to test the comparative advantages of raloxifene with those of bazedoxifene, a more recently developed SERM. Research on a number of adverse side effects of SERM agents is being performed to determine the long-term safety of this class of compouds for treatment of osteoporosis.

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Benign Gynecological Diseases and SERMs

Palomba¹,

Zullo²

Selective Estrogen Receptor Modulators

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GnRH agonists and add‐back therapy: is there a perfect combination?

Cited by 58 publications

References 170 publications

GnRH analogs for the treatment of symptomatic uterine leiomyomas

GnRH analogs for the treatment of symptomatic uterine leiomyomas

Selective Estrogen Receptor Modulators

Benign Gynecological Diseases and SERMs

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