Dienogest for adolescents with endometriosis?

A multicenter open-label study of dienogest underscores the need to tailor treatment of endometriosis to an adolescent’s risk factors for osteoporosis. Published in The Journal of Pediatric and Adolescent Gynecology, the findings showed that the progestin substantially reduced endometriosis-related pain but also decreased lumbar bone mineral density (BMD).

For the VISanne study to assess adolescents, conducted in 21 study centers in 6 European countries, 111 adolescents aged 12 to <18 years who had clinically suspected or laparoscopically confirmed endometriosis were administered dienogest 2 mg once daily. Mean lumbar BMD at baseline was 1.1046 in the cohort.

Mean relative change in BMD from baseline was -1.2% (SD, 2.23%, n=103) at the end of treatment and mean lumbar BMD was -2.3%. Six months later, lumbar BMD had recovered somewhat, to a mean of -0.6%. At baseline, the mean endometriosis-associated pain score was 64.3 mm (SD, 19.1) and fell to 9.0 mm (SD, 13.9) by week 48.

“Because bone accretion is critical during adolescence,” wrote the authors, “results of the VISanne study to assess safety in adolescents (VISADO) study highlights the need for tailored treatment in this population, taking into account the expected efficacy on endometriosis-associated pain and an individual’s risk factors for osteoporosis.”