Popularity of endocrine endometriosis drugs and limited alternatives in the present and foreseeable future: A survey among 1420 affected women

Burla, Laurin; Kalaitzopoulos, Dimitrios Rafail; Metzler, Julian Matthias; Scheiner, David; Imesch, Patrick

doi:10.1016/j.ejogrb.2021.05.040

Cited by 17 publications

(10 citation statements)

References 39 publications

(42 reference statements)

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“…While hormonal drugs are the mainstay of current therapeutics, a recent survey of 1420 patients with endometriosis in Austria, Germany, and Switzerland found that an overwhelming proportion of them hold a negative attitude toward hormonal drugs, and the majority of them disliked the side effects of these drugs, especially amongst young, city-dwelling, educated women (Burla et al 2021). Remarkably, 95.3% of the surveyees expressed preference for plant-based products, preferably in oral form (Burla et al 2021). This demand contrasts sharply with resounding failure in clinical trials on non-hormonal drugs in endometriosis and adenomyosis (Guo & Evers 2013, Guo 2014) and highlights the medical need that has not been fulfilled.…”

Section: Development Of Novel Therapeuticsmentioning

confidence: 99%

Cracking the enigma of adenomyosis: an update on its pathogenesis and pathophysiology

Guo

2022

Reproduction

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Traditionally considered as an enigmatic disease, adenomyosis is a uterine disease that affects many women of reproductive age, and is a contributing factor for pelvic pain, heavy menstrual bleeding (HMB), and subfertility. In this review, the new development on the pathogenesis and pathophysiology of adenomyosis has been summarized, along with their clinical implications. After reviewing the progress on our understanding of the pathogenesis and describing the prevailing theories, in conjunction with their deficiencies, a new hypothesis, called endometrial-myometrial interface disruption (EMID), which is backed by extensive epidemiologic data and demonstrated by a mouse model, is reviewed, along with recent data implicating the role of Schwann cells in the EMI area in the genesis of adenomyosis. Additionally, the natural history of adenomyotic lesions is elaborated and underscores that, ] in essence, adenomyotic lesions are fundamentally wounds undergoing repeated tissue injury and repair (ReTIAR), which progress to fibrosis through epithelial-mesenchymal transition, fibroblast-to-myofibroblast transdifferentiation, and smooth muscle metaplasia. Increasing lesional fibrosis propagates into the neighboring the EMI and endometrium. The increased endometrial fibrosis, with ensuing greater tissue stiffness, results in attenuated prostaglandin E2 (PGE2) and hypoxia signaling, impairing endometrial repair and causing HMB. Compared with adenomyosis-associated HMB, the mechanisms underlying adenomyosis-associated pain is less understood, but presumably involves increased uterine contractility, hyperinnervation, increased lesional production of pain mediators, and central sensitization. Viewed through the prism of ReTIAR, new imaging technique can be used to diagnosis adenomyosis and possibly help to choose the best treatment modality.

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Section: Development Of Novel Therapeuticsmentioning

confidence: 99%

Cracking the enigma of adenomyosis: an update on its pathogenesis and pathophysiology

Guo

2022

Reproduction

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“…Even though there is an abundance of endometriosis-related information online, filtering and assessing the quality of information can be challenging, as people make little use of source credibility [ 13 ]. Available information on endometriosis is often of low quality, inaccurate, or skewed toward the diagnosis or it conveys negative connotations, while high-quality information is challenging for a lay audience to comprehend [ 14 , 15 ]. These circumstances can induce feelings of fear and helplessness [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Examining the Influence on Perceptions of Endometriosis via Analysis of Social Media Posts: Cross-sectional Study

Metzler¹,

Kalaitzopoulos²,

Burla³

et al. 2022

JMIR Form Res

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Background Social media platforms, such as Facebook and Instagram, are increasingly being used to share health-related information by “influencers,” regular users, and institutions alike. While patients may benefit in various ways from these interactions, little is known about the types of endometriosis-related information published on social media. As digital opinion leaders influence the perceptions of their followers, physicians need to be aware about ideas and beliefs that are available online, in order to address possible misconceptions and provide optimal patient care. Objective The aim of this study was to identify and analyze frequent endometriosis-related discussion topics on social media in order to offer caregivers insight into commonly discussed subject matter and aspects. Methods We performed a systematic search using predefined parameters. Using the term “endometriosis” in Facebook’s search function and a social media search engine, a list of Facebook pages was generated. A list of Instagram accounts was generated using the terms “endometriosis” and “endo” in Instagram’s search function. Pages and accounts in English with 5000 or more followers or likes were included. Nonpublic, unrelated, or inactive pages and accounts were excluded. For each account, the most recent 10 posts were identified and categorized by two independent examiners using qualitative content analysis. User engagement was calculated using the numbers of interactions (ie, shares, likes, and comments) for each post, stratified by the number of followers. Results A total of 39 Facebook pages and 43 Instagram accounts with approximately 1.4 million followers were identified. Hospitals and medical centers made up 15% (6/39) of the Facebook pages and 5% (2/43) of the Instagram accounts. Top accounts had up to 111,600 (Facebook) and 41,400 (Instagram) followers. A total of 820 posts were analyzed. On Facebook, most posts were categorized as “awareness” (101/390, 25.9% of posts), “education and research” (71/390, 18.2%), and “promotion” (64/390, 16.4%). On Instagram, the top categories were “inspiration and support” (120/430, 27.9% of posts), “awareness” (72/430, 16.7%), and “personal story” (72/430, 16.7%). The frequency of most categories differed significantly between platforms. User engagement was higher on Instagram than on Facebook (3.20% vs 0.97% of followers per post). On Instagram, the highest percentage of users engaged with posts categorized as “humor” (mean 4.19%, SD 4.53%), “personal story” (mean 3.02%, SD 4.95%), and “inspiration and support” (mean 2.83%, SD 3.08%). On Facebook, posts in the categories “awareness” (mean 2.05%, SD 15.56%), “humor” (mean 0.91%, SD 1.07%), and “inspiration and support” (mean 0.56%, SD 1.37%) induced the most user engagement. Posts made by hospitals and medical centers generated higher user engagement than posts by regular accounts on Facebook (mean 1.44%, SD 1.11% vs mean 0.88%, SD 2.71% of followers per post) and Instagram (mean 3.33%, SD 1.21% vs mean 3.19%, SD 2.52% of followers per post). Conclusions Facebook and Instagram are widely used to share endometriosis-related information among a large number of users. Most posts offer inspiration or support, spread awareness about the disease, or cover personal issues. Followers mostly engage with posts with a humoristic, supportive, and awareness-generating nature. Health care providers should be aware about the topics discussed online, as this may lead to an increased understanding of the needs and demands of digitally proficient patients with endometriosis.

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“…Unfortunately, the development of non-hormonal drugs for endometriosis so far has been painfully stagnant [ 9 , 10 ], and the resultant disappointment is palpable [ 11 ]. Remarkably, a recent study reports that nearly 90% of patients with endometriosis are not satisfied with hormonal drugs, and over 95% of patients would have preferred plant-based products [ 12 ]. This study provides a strong impetus to search for novel non-hormonal drugs for endometriosis.…”

Section: Introductionmentioning

confidence: 99%

Tetramethylpyrazine Retards the Progression and Fibrogenesis of Endometriosis

et al. 2022

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The development of more efficacious, non-hormonal therapeutics for endometriosis is still an unmet medical need begging to be fulfilled. Growing evidence indicates that endometriotic lesions are wounds undergoing repeated tissue injury and repair, and, as such, platelets play an important role in lesional progression. Tetramethylpyrazine (TMP), a compound derived from a herb that has been used for thousands of years to combat “blood stasis” in traditional Chinese medicine, is a prescription drug in China for the treatment of cerebrovascular disorders. We tested the hypothesis that TMP can decelerate lesional progression through arresting epithelial-mesenchymal transition (EMT), fibroblast-to-myofibroblast transdifferentiation (FMT), and fibrogenesis. We found in our in vitro experiments that TMP treatment suppresses platelet-induced EMT, FMT, cellular contractility, and collagen production in a concentration-dependent manner. We also showed that in a mouse model of endometriosis, treatment with TMP significantly reduced lesion weight and the extent of lesional fibrosis and improved hyperalgesia, mostly likely through the reduction of lesional aggregation of platelets and the lesional expression of markers of EMT, FMT, and fibrogenesis. In light of our results and in view of its excellent safety profiles, TMP appears to be a promising drug candidate for treating endometriosis.

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Popularity of endocrine endometriosis drugs and limited alternatives in the present and foreseeable future: A survey among 1420 affected women

Cited by 17 publications

References 39 publications

Cracking the enigma of adenomyosis: an update on its pathogenesis and pathophysiology

Cracking the enigma of adenomyosis: an update on its pathogenesis and pathophysiology

Examining the Influence on Perceptions of Endometriosis via Analysis of Social Media Posts: Cross-sectional Study

Tetramethylpyrazine Retards the Progression and Fibrogenesis of Endometriosis

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