Analogues in Endometriosis

September 19, 2006
Hans Van Der Slikke, MD

OBGYN.net Conference CoverageFrom 6th GnRH Analogue ConferenceGeneva, Switzerland February 2001

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Dr. Hans van der Slikke: "Good morning, we're here at the Analogues Conference in Geneva, and next to me is Dr. Henk Franke who presented about analogues in endometriosis. What special topic about analogues did you address, Henk?"

Dr. Henk Franke: "We performed a prospective randomized control trial in the Netherlands for a couple of years, and in forty-one patients we performed a laparoscopy before treatment, and we did not remove the endometriotic implants if we found them intraperitoneally. We then started treatment with Zoladex, a GnRH agonist depot formulation, once a month for six months. It's a placebo-controlled trial so after six months we performed a laparoscopy again, and if implants were found, we then removed them. However, in both groups we found a significant reduction of endometriosis."

Dr. Hans van der Slikke: "Why did you give this add-back therapy with it?"

Dr. Henk Franke: "Firstly, if you use a GnRH agonist depot, a lot of patients complain of climacteric complaints and, secondly, you can see a decrease in the bone mineral density. In the group of patients using a placebo, we saw a decrease in the bone mineral density of 5%. In the patients using an add-back that was a continuous combined estrogen-progestin combination, we saw an increase of the bone mineral density of 0.18%."

Dr. Hans van der Slikke: "So this means analogues can be given for a longer period and remain effective?"

Dr. Henk Franke: "Of course, you can extend the boundaries of therapy and use it for more than six months. Also, you know it's effective and what is essential is the add-back therapy does not interfere with the efficacy of the treatment so you can give it, for instance, for a year or two years. We are now performing a study where we would give patients - not endometriotic patients - but climacteric patients with dysfunctional bleeding from the uterus two years of a GnRH agonist depot and also with add-back."

Dr. Hans van der Slikke: "I'm curious and I'm looking forward to the results of this study."

Dr. Henk Franke: "You're welcome."

Dr. Hans van der Slikke: "Thank you very much."

Dr. Henk Franke: "Thank you."