Gonadotropin-releasing hormone antagonists versus agonists for endometriosis: a systematic review and meta-analysis of randomized controlled trials.

What was studied

This review compared hormone drugs for endometriosis. One kind is the GnRH agonist leuprolide. The other kind is GnRH antagonists, taken by mouth. It pooled randomized trials. It looked at pain, pelvic signs, bone density and quality of life. It also looked at hormone levels.

What they found

The agonist gave greater relief of period pain. The effect size was 0.69. It also gave greater relief of pelvic pain. Effect sizes were 0.33, 0.25 and 0.14 for other pain measures. It was also better for analgesic need and menstrual blood loss. Pain relief was larger after 12 weeks. The antagonists caused less bone density loss. The effect size was 0.64. Most quality-of-life domains did not differ.

What it means for patients

The authors say the agonist gives stronger symptom control. They say the antagonists give less bone loss and reversible suppression. They say the choice should fit symptoms, bone health and fertility goals.

Why it is not certain yet

The authors say the antagonists differ from each other. They call for long-term head-to-head trials. The abstract does not give side effects beyond bone density. A review can only be as good as the trials in it.

Source

Gonadotropin-releasing hormone antagonists versus agonists for endometriosis: a systematic review and meta-analysis of randomized controlled trials.

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