Efficacy, safety and mechanism of new progestin and selective progesterone receptor modulator (SPRM) for treatment of endometriosis
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To compare therapeutic and side effects and anti‐endometriosis mechanisms of Esmya (a partial agonistic and antagonistic SPRM), Duphaston (a semi‐synthesized retroprogesterone group progestin) and Dienogest (a 19‐ortestosterone group progestin) in endometriosis.
Animal studies in mice.
Materials and methods:
Experimental endometriosis was induced by intraperitoneal endometrium transplantation. Mice were randomly administered with Esmya, Duphaston, Dienogest or vehicle for 4 weeks. Lesion size, weight and histology were compared. Adhesion, invasion, proliferation, angiogenesis and survival were examined. Body, uterus and ovary weights, endometrial glands and thickness, and follicle counts were monitored.
After Esmya, Duphaston, Dienogest treatment, lesion size and weight were significantly decreased and endometriotic gland and epithelium were degraded and underdeveloped. Amongst all, Dienogest had the smallest lesions. Adhesion Itgv3, proliferation Pcna and invasion Plau mRNA expression were significantly decreased in treatment groups. Apoptosis Mapk1 mRNA expression and TUNEL‐positive cells were significantly increased in Duphaston and Dienogest group only. Angiogenesis HIF1 and VEGFA mRNA expression were not significantly different from control. Peritoneal fluid PGE2 levels were not significant different but PGP9.5 nerve innervations in the lesions were significantly decreased in Duphaston and Dienogest. There were no significant changes in body, uterus and ovary weights; blood E2, P, FSH and LH levels; endometrial gland counts and thickness, but antral follicle counts were significantly lower in Esyma.
Esmya, Duphaston and Dienogest are effective anti‐endometriosis drugs targeting adhesion, proliferation and invasion, but not angiogenesis. Duphaston and Dienogest can further induce apoptosis, may also reduce endometriotic pain. Esmya, Duphaston and Dienogest are all well tolerable, except ovarian reserve is reduced with Esyma. Recurrence after withdraw is unknown.
Esmya, Duphaston, Dienogest
All Author(s) ListLiang Bo , Wu Ling , Cheung Eva Chun Wai , Fung Linda Wen Ying , Wong Alysa Sze Wai , Wang Chi Chiu
Name of ConferenceThe 13th World Congress on Endometriosis
Start Date of Conference17/05/2017
End Date of Conference20/05/2017
Place of ConferenceVancouver
Country/Region of ConferenceCanada
LanguagesEnglish-United States
KeywordsEsmya, Duphaston, Dienogest

Last updated on 2018-18-01 at 03:06