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Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis: a systematic review and meta-analysis

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Abstract

Purpose

Endometriosis is a common chronic gynecological disease defined as the presence of endometrial glands and stroma tissue outside the uterus. Gestrinone is an effective antiestrogen that induces endometrial atrophy and/or amenorrhea. The purpose of this systematic review is to provide an evaluation of safety and effectiveness of gestrinone for the treatment of endometriosis.

Methods

We performed a search in six electronic databases: PubMed, MEDLINE (ovid), Embase, Cochrane CENTRAL (clinical trials), Web of Science and Scopus. Our selected primary outcomes were the changes in dysmenorrhea, pain relief including pelvic pain and dyspareunia. The secondary outcomes embrace hormones parameters, pregnancy rate and adverse events.

Results

Of 3269 references screened, 16 studies were included involving 1286 women. All studies compared gestrinone with other drugs treatments (placebo, Danazol, Mifepristone tablets, Leuprolide acetate, Quyu Jiedu Recipe) during 6 months. When compared with other drugs treatments, gestrinone relieved dysmenorrhea, pelvic pain, and morphologic response in the ovary. There was an increase on the pregnancy rate. Regarding the side effects observed, gestrinone showed the same adverse events and increased the risk of acne and seborrhea when compared to other treatments. Even if there was any difference in efficacy between gestrinone, danazol, leuprolide acetate, or Quyu Jiedu Recipe Chinese Medicine, it remains unclear due to insufficient data.

Conclusion

Based limited evidence available suggests that gestrinone appeared to be safe and may have some efficacy advantages over danazol, as well as other therapeutic interventions for treating endometriosis. However, this conclusion should be interpreted with caution, due the quality of the evidence provided is generally very low or unclear.

Trial registration

CRD42021284148.

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Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico, 160162/2019-0, Gustavo Ferrari.

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Authors and Affiliations

  1. CITH—Integrated Hormone Treatment Center, Curitiba, PR, Brazil

    Luiz Paulo de Souza Pinto

  2. Iaso Biodelivery Fabricação de Dispositivos com Liberação de Fármacos LTDA, Florianópolis, SC, Brazil

    Gustavo Ferrari & Izabelle de Mello Gindri

  3. Biomechanics Engineering Laboratory, Department of Mechanical Engineering, University Hospital &, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil

    Gustavo Ferrari & Carlos Rodrigo de Mello Roesler

  4. Bio Meds Pharmaceutica LTDA, Florianópolis, SC, 88050-001, Brazil

    Gustavo Ferrari & Izabelle de Mello Gindri

  5. NIMMA—Núcleo de Inovação em Moldagem e Manufatura Aditiva, Department of Mechanical Engineering, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil

    Gustavo Ferrari

  6. State University of Rio Grande do Norte, Natal, Mossoró, RN, Brazil

    Isis Kelly dos Santos

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  1. Luiz Paulo de Souza Pinto
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  5. Izabelle de Mello Gindri
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Contributions

GF: study concept, data search and extraction, data analysis, and draft writing. IKS: study concept, conducted protocol, data extraction, data analysis, and draft writing. IMG: study concept, conducted the searchers, resolve conflicts, and draft review. CPMR: study concept and draft review. LPSP: study concept, and draft review.

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Correspondence to Izabelle de Mello Gindri.

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de Souza Pinto, L.P., Ferrari, G., dos Santos, I.K. et al. Evaluation of safety and effectiveness of gestrinone in the treatment of endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet 307, 21–37 (2023). https://doi.org/10.1007/s00404-022-06846-0

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