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Norethindrone Acetate or Dienogest for the Treatment of Symptomatic Endometriosis: A Before and After Study

Norethindrone Acetate or Dienogest for the Treatment of Symptomatic Endometriosis: A Before and After Study

Paolo Vercellini, Benedetta Bracco, Paola Mosconi, Anna Roberto, Daniela Alberico, Dridi Dhouha, Edgardo Somigliana

Fertil Steril. 2016 Mar;105(3):734-743.e3.

PMID: 26677792

Abstract:

Objective:
To assess the proportion of patients satisfied with their treatment before and after a systematic change from norethindrone acetate to dienogest as the first-line progestin for symptomatic endometriosis.
Design:
Before and after study.
Setting:
Academic department.
Patient(s):
The last 90 new consecutive endometriosis patients in whom norethindrone acetate was used, and the first 90 new consecutive endometriosis patients in whom dienogest was used.
Intervention(s):
Norethindrone acetate at the oral dose of 2.5 mg once a day until June 6, 2013, then dienogest at the oral dose of 2 mg once a day thereafter.
Main outcome measure(s):
Degree of satisfaction with treatment after 6 months of progestin therapy and assessment of any variations in pain symptoms, psychological status, sexual function, or health-related quality of life associated with the introduction of dienogest.
Result(s):
The proportion of satisfied plus very satisfied women after 6 months of treatment was 71% in the "before" period (norethindrone acetate) and 72% in the "after" period (dienogest). The implementation of dienogest was not associated with statistically significant ameliorations in overall pain relief, psychological status, sexual functioning, or health-related quality of life. Treatment was well tolerated by 58% of norethindrone acetate users compared with 80% of dienogest users. After dienogest implementation, the absolute risk reduction in the occurrence of any side effect was 13.9% (95% confidence interval, 0.8%-28.6%).
Conclusion(s):
Considering the large difference in the cost of the two drugs, dienogest should be suggested selectively in women who do not tolerate norethindrone acetate.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP51989-B	Norethindrone acetate		51-98-9	Price

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