The Systemic Effects of Endometriosis

Alderman, Myles H.; Yoder, Nicole; Taylor, Hugh S.

doi:10.1055/s-0037-1603582

Cited by 35 publications

(23 citation statements)

References 105 publications

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“…Women with this disease are more likely to have depression, anxiety, autoimmune disease, and a lower average body mass index. 154 The regenerative ability of endometrium and use of circulating stem cells may allow for regeneration after menstruation and enhance fertility; however, it may predispose menstruating animals to endometriosis and associated disease. Endometriosis can be considered a systemic disease in which widespread cell trafficking contributes to the pathophysiology.…”

Section: B Regeneration After Menstruationthe Role Of Stem Cellsmentioning

confidence: 99%

See 1 more Smart Citation

Menstruation: science and society

Critchley

Babayev

Bulun

et al. 2020

American Journal of Obstetrics and Gynecology

224

172

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H.O.D.C. has clinical research support for laboratory consumables and staff from Bayer AG and provides consultancy advice (but with no personal remuneration) for Bayer AG, PregLem SA, Gedeon Richter, Vifor Pharma UK Ltd, AbbVie Inc, and Myovant Sciences GmbH. H.O.D.C. receives royalties from UpToDate for article on abnormal uterine bleeding. A.K. receives royalties from UpToDate, Wolters Kluwer for work on the topic hysterosalpingography. E.E.M. consults for Myovant Sciences. K.A.M. is coinvestigator for Bayer Essure longitudinal research study and clinical trial (all funds for this research go to the site of research [W.I.H.] e no personal compensation). K.A.M. is scientific advisor for Myovant (advises on patient questionnaires related to AUB-compensation goes to employer [C.N.E.M.G.]-no personal compensation). K.A.M. has received honoraria from ABOG, ACOG, and NIH for participating in working groups and meetings. K.A.M. is HHS Office of Population Affairs Title X Grant Reviewer (received honorarium). I.M. is employee of Igenomix R&D. C.S. is Head of the Igenomix Scientific Advisory Board. The other authors report no conflict of interest.

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Section: B Regeneration After Menstruationthe Role Of Stem Cellsmentioning

confidence: 99%

“…Endometriosis can be considered a systemic disease in which widespread cell trafficking contributes to the pathophysiology. 154 VI. Endometrium, stem cells, and pregnancy.…”

Section: B Regeneration After Menstruationthe Role Of Stem Cellsmentioning

confidence: 99%

Menstruation: science and society

Critchley

Babayev

Bulun

et al. 2020

American Journal of Obstetrics and Gynecology

224

172

View full text Add to dashboard Cite

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“…Our findings on the sizeable impact of comorbidities on healthcare spending among women with endometriosis underscore two important points for providers and payers: this patient population exhibits pronounced heterogeneity in expected resource use, and there are potential benefits of comorbidity prevention and early detection efforts. Additional implications of these findings for clinical practice depend largely on the relationship between endometriosis diagnosis and development of subsequent comorbidities [ 29 ]. Selection of the 22 comorbidities to study was based on epidemiological evidence of endometriosis–comorbidity associations.…”

Section: Discussionmentioning

confidence: 99%

Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Epstein¹,

Soliman

Davis³

et al. 2017

Adv Ther

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IntroductionWe sought to characterize changes in healthcare spending associated with the onset of 22 endometriosis-related comorbidities.MethodsWomen aged 18–49 years with endometriosis (N = 180,278) were extracted from 2006–2015 de-identified Clinformatics® DataMart claims data. For 22 comorbidities, comorbidity patients were identified on the basis of having a first comorbidity diagnosis after their initial endometriosis diagnosis. Controls were identified on the basis of having no comorbidity diagnosis and were matched 1:1 to comorbidity patients on demographics and baseline spending. Total medical and pharmacy spending was measured during 12 months before and after each patient’s index date (first comorbidity diagnosis for comorbidity patients, and equal number of days after earliest endometriosis claim for controls). Pre–post spending differences were compared using difference-in-differences linear regression. Total and comorbidity-related cumulative spending per patient for all endometriosis patients were calculated annually for the 5 years following endometriosis diagnosis.ResultsThe number of endometriosis patients with each comorbidity varied between 121 for endometrial cancer and 16,177 for fatigue. Healthcare spending increased significantly with the onset of eight comorbidities: breast cancer, ovarian cancer, pregnancy complications, systemic lupus erythematosus/rheumatoid arthritis/Sjogren’s/multiple sclerosis, infertility, uterine fibroids, ovarian cyst, and headache [p < 0.001 except for headache (p = 0.045)]. Spending decreased significantly for fatigue, cystitis/UTI, and eczema [p < 0.001 except for fatigue (p = 0.048)] and was not statistically different for the other 11 comorbidities. Difference-in-differences estimates were significantly higher for comorbidity patients for all comorbidities except eczema (p ≤ 0.003). Mean 5-year total cumulative spending was $58,191 per endometriosis patient, of which between 11% and 23% was attributable to comorbidity-related medical claims.ConclusionFor all but one of the 22 comorbidities associated with endometriosis, comorbidity onset was associated with a relative increase in total healthcare spending.FundingAbbVie Inc.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0630-8) contains supplementary material, which is available to authorized users.

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“…The hypothesis that stem cells contribute to the establishment and progression of endometriotic lesions has gained wide acceptance [ 4 , 10 , 11 , 42 , 48 , 49 ]. However, the available direct evidence to confirm this hypothesis remains limited.…”

Section: Tubal Origins Of Endometriosismentioning

confidence: 99%

Endometriosis and the Fallopian Tubes: Theories of Origin and Clinical Implications

Hill

Fakhreldin

Maclean

et al. 2020

JCM

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Endometriosis is a common, oestrogen driven chronic condition, where endometrium-like epithelial and stromal cells exist in ectopic sites. At present, no curative treatments are available and the existing evidence for disease progression is conflicting. The pathogenesis is still unknown and evidently complex, as mechanisms of initiation may depend on the anatomical distribution of endometriotic lesions. However, amongst the numerous theories and plethora of mechanisms, contributions of the fallopian tubes (FT) to endometriosis are rarely discussed. The FT are implicated in all endometriosis associated symptomatology and clinical consequences; they may contribute to the origin of endometriotic tissue, determine the sites for ectopic lesion establishment and act as conduits for the spread of proinflammatory media. Here, we examine the available evidence for the contribution of the human FT to the origin, pathogenesis and symptoms/clinical consequences of endometriosis. We also examine the broader topic linking endometriosis and the FT epithelium to the genesis of ovarian epithelial cancers. Further studies elucidating the distinct functional and phenotypical characteristics of FT mucosa may allow the development of novel treatment strategies for endometriosis that are potentially curative.

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The Systemic Effects of Endometriosis

Cited by 35 publications

References 105 publications

Menstruation: science and society

Menstruation: science and society

Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Endometriosis and the Fallopian Tubes: Theories of Origin and Clinical Implications

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