Rapid reduction of adenomyosis coexisting with leiomyoma volume during treatment with Relugolix

Yamanaka, Keitaro; Washio, Keiichi; Uchida, Atsushi; Sasagawa, Yuki; Nishimoto, Masashi; Yamasaki, Yui; Nagamata, Satoshi; Terai, Yoshito

doi:10.1080/09513590.2023.2237121

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…Irrespective of the group, adenomyosis showed a significant reduction compared with uterine fibroids ( p < 0.001). There was no statistically significant difference in the mitigation of symptoms (amenorrhea, pelvic pain, and anemia) between patients with adenomyosis coexisting with fibroids and those with only fibroids [ 72 ].…”

Section: The Role Of Medical Therapy For Treating Symptoms Related To...mentioning

confidence: 99%

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Etrusco,

Barra,

Chiantera

et al. 2023

Drugs

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Adenomyosis, characterized by the growth of endometrial tissue within the uterine wall, poses significant challenges in treatment. The literature primarily focuses on managing abnormal uterine bleeding (AUB) and dysmenorrhea, the main symptoms of adenomyosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) and tranexamic acid provide limited support for mild symptoms or symptom re-exacerbation during hormone therapy. The levonorgestrel-releasing intrauterine system (LNG-IUS) is commonly employed in adenomyosis management, showing promise in symptom improvement and reducing uterine size, despite the lack of standardized guidelines. Dienogest (DNG) also exhibits potential benefits, but limited evidence hinders treatment recommendations. Danazol, while effective, is limited by androgenic side effects. Combined oral contraceptives (COCs) may be less effective than progestins but can be considered for contraception in young patients. Gonadotropin-releasing hormone (GnRH) agonists effectively manage symptoms but induce menopausal symptoms with prolonged use. GnRH antagonists are a recent option requiring further investigation. Aromatase inhibitors (AIs) show promise in alleviating AUB and pelvic pain, but their safety necessitates exploration and limited use within trials for refractory patients. This review highlights the complexity of diagnosing adenomyosis, its coexistence with endometriosis and uterine leiomyomas, and its impact on fertility and quality of life, complicating treatment decisions. It emphasizes the need for research on guidelines for medical management, fertility outcomes, long-term effects of therapies, and exploration of new investigational targets. Future research should optimize therapeutic strategies, expand our understanding of adenomyosis and its management, and establish evidence-based guidelines to improve patient outcomes and quality of life.

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Section: The Role Of Medical Therapy For Treating Symptoms Related To...mentioning

confidence: 99%

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Etrusco,

Barra,

Chiantera

et al. 2023

Drugs

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“…Relugolix, a gonadotropin-releasing hormone antagonist, was approved by the US Food and Drug Administration in May 2021 as an oral medication for treating heavy menstrual bleeding due to uterine fibroids [ 1 ]. Known to significantly reduce menstrual blood while preserving bone density, relugolix is also used preoperatively to reduce the uterine volume [ 2 ]. Its side effects include hypoestrogenic symptoms, such as hot flashes, insomnia, and headaches [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Rheumatoid Arthritis-Like Symptoms After Taking Relugolix, With Primary Exacerbation After Discontinuation of the Drug

Tanabe,

Tsuboi

2024

Cureus

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We report a case of a 43-year-old woman who developed rheumatoid arthritis-like symptoms after taking relugolix, presenting a diagnostic challenge in distinguishing between initial symptoms of rheumatoid arthritis and the side effects of the drug. The patient, scheduled for a total laparoscopic hysterectomy owing to uterine fibroids, started taking relugolix five and a half months prior to surgery. Three months later, she developed rheumatoid arthritis-like stiffness in both hands, especially in the mornings. Despite consultations with the rheumatology department and negative blood and imaging findings for rheumatoid arthritis, her joint symptoms worsened after surgery. Treatment for early-stage rheumatoid arthritis was initiated, and the symptoms peaked after six months. Similar to estrogen-lowering aromatase inhibitors that are known to cause joint symptoms, relugolix might also induce these effects.

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“…Therefore, the effect of relugolix on uterine adenomyosis has only been reported in cases of uterine adenomyosis associated with uterine fibroids. 12,13 Specifically, the effect of relugolix on the uteri of patients with adenomyosis without uterine fibroids has not yet been clarified.…”

Section: Introductionmentioning

confidence: 99%

Gonadotropin-releasing hormone antagonist (relugolix) for treatment of uterine adenomyosis with symptomatic endometriosis

Matsushima,

Nagashima,

Harigane

et al. 2024

Journal of Endometriosis and Pelvic Pain Disorders

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Objective: To determine the effects of relugolix administration for uterine adenomyosis on uterine volume and subjective symptoms. Methods: This retrospective observational study included 30 patients with clinical symptoms of endometriosis complicated with uterine adenomyosis who were treated with 40 mg/day of relugolix orally for >16 weeks. The uterine volume was calculated pre- and post-administration, and the volume percentage post-administration. Furthermore, the presence or absence of subjective post-administration symptoms and adverse effects were also examined. Results: The median (interquartile range) long diameter, short diameter, width, and volume of the patients’ uteri pre- and post-administration of relugolix significantly decreased from 9.63 (9.02–11.00) to 8.00 (6.84–9.12) cm, 6.47 (5.58–8.02) to 5.00 (4.26–5.63) cm, 6.91 (5.68–8.46) to 5.49 (4.58–6.00) cm, and 221.04 (146.52–390.26) to 111.90 (71.59–165.84) cm3, respectively ( p < 0.001 for all four items). Additionally, the uterus volume post-administration was 48.30% (33.88–62.54%) of that pre-administration. Heavy menstrual bleeding, dysmenorrhea, and chronic pelvic pain occurred in 23 (76.7%), 21 (70.0%), and 13 (43.3%) of the 30 patients, respectively; however, all patients experienced resolution of all symptoms. Nine, three, and one patients had hot flashes, mild arthralgia, and a mild headache, respectively. No cases of persistent irregular or heavy bleeding were observed during treatment. Conclusions: Relugolix contributes to volume reduction and eliminates subjective symptoms of uterine adenomyosis, suggesting that it is an effective treatment for uterine adenomyosis.

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Rapid reduction of adenomyosis coexisting with leiomyoma volume during treatment with Relugolix

Cited by 3 publications

References 24 publications

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Rheumatoid Arthritis-Like Symptoms After Taking Relugolix, With Primary Exacerbation After Discontinuation of the Drug

Gonadotropin-releasing hormone antagonist (relugolix) for treatment of uterine adenomyosis with symptomatic endometriosis

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