Metformin for the treatment of endometrial hyperplasia.

Ko, Emily; Sullivan, Stephanie; Rambally, Brooke; O’Connor, Siobhán; Everett, Ruth; Thakker, Dhiren R.; Moore, Dominic T.; Byron, John; Bae‐Jump, Victoria L.

doi:10.1200/jco.2016.34.15_suppl.5592

Cited by 2 publications

(5 citation statements)

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“…There was also a significant decrease in mean BMI in LNG-IUS plus metformin group. We agree with Korkmaz et al that metformin may be used as an adjunctive therapy for persistent EH in women with high BMI (Korkmaz et al, 2013).…”

Section: Discussionsupporting

confidence: 92%

“…Like other studies, no severe adverse effects were observed in both arms of the study (Shan et al, 2014). Emily M et al had observed diarrhoea as the most common adverse effect, which was not observed in our study (Emily Meichun Ko et al, 2016).…”

Section: Discussioncontrasting

confidence: 69%

“…The mean HOMA IR in the study was 2•402 which being greater than 2 suggests insulin resistance for Indian population (Sinha DP et al, 2009). Even though the mean ET (13.68mm) was comparable to other studies (Sayyah-Melli et al, 2018;Korkmaz et al, 2013), our study did not show any significant correlation between ET and BMI in contrast to prior studies. Earlier studies have demonstrated increase in ET with increased BMI (Douchi et al, 1998;Heller et al, 2011).…”

Section: Discussionsupporting

confidence: 58%

“…Even though adding metformin to the first line management (LNG-IUS) showed a better histopathological response, it was not statistically significant as noted in the previous studies (Shan et al, 2014;Korkmaz et al, 2013). Seventy eight percent of the total study subjects had pill endometrium on histopathological response assessment and atrophic endometrium was observed only in group M patients (12•5% ).…”

Section: Discussionmentioning

confidence: 56%

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A Randomized Clinical Trial of Levonorgestrel Intrauterine System with or without Metformin for Treatment of Endometrial Hyperplasia without Atypia in Indian Women

Ravi

Kalra

Srinivasan

et al. 2021

Asian Pac J Cancer Prev

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Background: Endometrial cancer is the second most frequent genital malignancy in women, which is showing a constant rise all over world. Endometrial hyperplasia is the precursor of endometrial cancer. Levonorgestrel intrauterine system is the first line management in patients with endometrial hyperplasia without atypia. Metformin has shown to reverse endometrial hyperplasia, but its effectiveness and safety in endometrial hyperplasia is uncertain. Objective: To compare the efficacy in terms of histopathological response, clinical response and safety at the end of 6 months in patients with endometrial hyperplasia without atypia managed with levonorgestrel intrauterine system alone versus patients managed with levonorgestrel intrauterine system plus metformin. Methods: The randomized control trial was conducted on 51 cases of endometrial hyperplasia without atypia. Twenty-five subjects were prescribed metformin 500mg twice daily with levonorgestrel intrauterine system and 26 subjects, with levonorgestrel intrauterine system only for 6 months. At the end of 6 months, endometrial sampling was performed for histopathological response. Results: Clinical response was observed in 23 of 25 subjects in metformin group and 22 of 24 in levonorgestrel only group. The metformin group responded significantly with amenorrhea (p= 0.0053), while levonorgestrel only group responded with regular cycles (p=0.027). At the end of study, of 46 subjects available for histopathological evaluation, 100% subjects in metformin group and 95.45% in levonorgestrel only group (p=0.47826) showed complete response. The metformin group had a significant reduction in body mass index at end of study [P = 0•023, 95% confidence interval (-1.7802, -0.1418)]. Conclusion: No significant difference in regression of endometrial hyperplasia was observed on adjunctive use of metformin but a significant reduction in BMI was observed. Use of metformin in obese patients may improve the treatment response.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 69%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 56%

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A Randomized Clinical Trial of Levonorgestrel Intrauterine System with or without Metformin for Treatment of Endometrial Hyperplasia without Atypia in Indian Women

Ravi

Kalra

Srinivasan

et al. 2021

Asian Pac J Cancer Prev

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“…The sample size was calculated at a significance level of 95%and an error level of 20% with a proportion of hyperplasia regression among Mirena group as 89% [16] and a proportion of hyperplasia regression among Metformin group as 56% [17]. A drop-out proportion of 10% was added to the raw result giving a final count of 25 women per group.…”

Section: Study Proceduresmentioning

confidence: 99%

Metformin versus levonorgestrel-releasing intrauterine system in the management of endometrial hyperplasia: a randomized clinical trial

Taha,

Abd-Elgelil,

Kishk

et al. 2023

Middle East Fertil Soc J

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Background Endometrial hyperplasia is one of the common causes of bleeding in perimenopausal women. Variable treatment options aim to induce regression. The current study evaluated the regression rate of endometrial hyperplasia after treatment with levonorgestrel intrauterine system (LNG- IUS) versus Metformin. Methods This randomized clinical trial was conducted at the obstetrics and gynecology department of Suez Canal University hospital. We recruited women diagnosed with endometrial hyperplasia without atypia. Patients were allocated into two groups. Group one included patients treated with levonorgestrel-releasing intrauterine system and group two treated with Metformin. The rate of regression of hyperplasia in both groups after six months of intervention was the main outcome measure. Results Significant regression of hyperplasia was noted in the LNG-IUS group (96% versus 64%, p-value 0.009). There was a significant decrease in the endometrial thickness after treatment in both groups (17.65 ± 4.62 and 5.3 ± 2.01 in the LNG- IUS with a p-value < 0.001) (19.57 ± 6.84 and 11.22 ± 7.51 in the metformin group with a p-value < 0.001). Factors that correlated with the Δ endometrial thickness included parity in the LNG- IUS group (p-value 0.019) and age and BMI in the metformin group (p-value 0.043 and 0.004 respectively). Conclusion Metformin had a regressive effect on endometrial hyperplasia; however, it was not significant as that achieved with the levonorgestrel intrauterine system. Trial registrations PACTR201908498370196. Date of registration: 21/8/2019. Date of first patient enrollment: 25/8/2019. URL: https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=9335

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Metformin for the treatment of endometrial hyperplasia.

Cited by 2 publications

References 0 publications

A Randomized Clinical Trial of Levonorgestrel Intrauterine System with or without Metformin for Treatment of Endometrial Hyperplasia without Atypia in Indian Women

A Randomized Clinical Trial of Levonorgestrel Intrauterine System with or without Metformin for Treatment of Endometrial Hyperplasia without Atypia in Indian Women

Metformin versus levonorgestrel-releasing intrauterine system in the management of endometrial hyperplasia: a randomized clinical trial

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