Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin): a pilot study with low-dose agonist therapy (“draw-back” therapy)

Tahara, Masahiro; Matsuoka, Taro; Yokoi, Takeshi; Tasaka, Keiichi; Kurachi, Hirohisa; Murata, Yuji

doi:10.1016/s0015-0282(99)00636-6

Cited by 36 publications

(15 citation statements)

References 24 publications

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“…For summarization, treatment groups were assigned into three suppression categories assuming a typical baseline E2 of ~100 pg/ml, which was the approximate average screening value across studies 28 , 29 , 30 . E2 was <15 pg/ml from each of the leuprolide and triptorelin treatment groups that did not include estradiol “add back.” These groups were assigned to the 90% suppression category.…”

Section: Resultsmentioning

confidence: 99%

Integrated Pharmacometrics and Systems Pharmacology Model‐Based Analyses to Guide GnRH Receptor Modulator Development for Management of Endometriosis

Riggs

Bennetts

Graaf

et al. 2012

CPT Pharmacom & Syst Pharma

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Endometriosis is a gynecological condition resulting from proliferation of endometrial-like tissue outside the endometrial cavity. Estrogen suppression therapies, mediated through gonadotropin-releasing hormone (GnRH) modulation, decrease endometriotic implants and diminish associated pain albeit at the expense of bone mineral density (BMD) loss. Our goal was to provide model-based guidance for GnRH-modulating clinical programs intended for endometriosis management. This included developing an estrogen suppression target expected to provide symptomatic relief with minimal BMD loss and to evaluate end points and study durations supportive of efficient development decisions. An existing multiscale model of calcium and bone was adapted to include systematic estrogen pharmacologic effects to describe estrogen concentration-related effects on BMD. A logistic regression fit to patient-level data from three clinical GnRH agonist (nafarelin) studies described the relationship of estrogen with endometrial-related pain. Targeting estradiol between 20 and 40 pg/ml was predicted to provide efficacious endometrial pain response while minimizing BMD effects.

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Section: Resultsmentioning

confidence: 99%

Integrated Pharmacometrics and Systems Pharmacology Model‐Based Analyses to Guide GnRH Receptor Modulator Development for Management of Endometriosis

Riggs

Bennetts

Graaf

et al. 2012

CPT Pharmacom & Syst Pharma

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“…Alternatively decreasing doses of GnRH-a [54], or increasing the interval between doses [55] has been shown to be as effective and less costly and to => hypoestrogenic environments likely that achieved by the conventional regimen. An earlier longitudinal prospective study showed that ½ dose administration of nafarelin after patient down regulation with full dose nafarelin (drawback therapy was associated with similar pain relief and less adverse effect on bone mineral density [56].…”

Section: Modifications In Ht Add Back Regimenmentioning

confidence: 99%

Use of Dienogest or Gonadotropin Releasing Hormone Agonist with Add back Hormone Therapy in Longterm Endometriosis Medical Management

Kaur¹

2018

OAJG

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Since endometriosis is a recurrent disease one needs longterm treatment for prevention of recurrence.2commonly used drugs for same are dienogest and gonadotropin releasing hormone agonists. There is not much experience with dienogest use, although enough experience exists regarding GnRH agonists. Important is to use add back hormone therapy with these agonists to prevent undesirable side effects. Rest selection of either of the drugs depends on cost, patient preference, drs experience, therapeutic effectiveness, tolerability and patients compliance expected. Thus we discuss the role of each agent in use for longterm endometriosis recurrence and in case of adolescents and patients presenting with endometriosis in young adults needing longterm therapy.

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“…In Anlehnung an die For-mulierung ¹add-backª haben Tahara et al [11] ihre Untersuchung mit reduzierter GnRH-Dosis ¹draw backª genannt. Nach initial üblicher Dosierung von 0,4 mg wurde Nafarelin nach 4 Wochen auf 0,2 mg reduziert.…”

Section: Medikamentöse Therapieunclassified

New Trends in the Conservative and Surgical Treatment of Endometriosis

Gätje

2002

Zentralbl Gynakol

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Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin): a pilot study with low-dose agonist therapy (“draw-back” therapy)

Cited by 36 publications

References 24 publications

Integrated Pharmacometrics and Systems Pharmacology Model‐Based Analyses to Guide GnRH Receptor Modulator Development for Management of Endometriosis

Integrated Pharmacometrics and Systems Pharmacology Model‐Based Analyses to Guide GnRH Receptor Modulator Development for Management of Endometriosis

Use of Dienogest or Gonadotropin Releasing Hormone Agonist with Add back Hormone Therapy in Longterm Endometriosis Medical Management

New Trends in the Conservative and Surgical Treatment of Endometriosis

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