ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
86
TO STUDY THE CLINICAL EFFICACY OF PATHOGENETIC THERAPY
IN WOMEN WITH GENITAL ENDOMETRIOSIS.
Mukhammadjonova M.M.
Gafurova F.A.
Center for the Development of Professional Qualifications of Medical Workers,
Department of Obstetrics, Gynecology and Perinatal Medicine, Tashkent
https://doi.org/10.5281/zenodo.16024592
Key words:
endometriosis, hormone-modulating therapy, alternative
treatment methods, dienogest, letrozole.
Introduction.
Endometriosis is a chronic hormone—dependent disease characterized by
an inflammatory reaction [1,2]. The chronic, progressive, and recurrent nature
of endometriosis makes it extremely urgent to search for new areas of targeted
therapy for genital endometriosis that have high therapeutic efficacy and
minimal side effects. Currently, the standard for specific therapy of
endometriosis is the use of dienogest 2 mg, which is a hybrid progestogen that
combines the best properties of the norsteroid and progesterone groups [5,7].
Currently, the main goal of modern therapy for genital endometriosis is not only
the suppression of the level of estrogens synthesized by the ovaries, but also the
pathogenetic effect on the site of endometriosis itself (suppression of local
estrogen production, overcoming progesterone resistance, antiproliferative and
antiangiogenic effects, increased apoptosis).
The purpose of the study
– to conduct a comparative assessment of the
effectiveness of alternative pathogenetic therapy for endometriosis.
Materials and methods.
A study was conducted on 40 women by forming two comparison groups.
In the group of women receiving dienogest and letrozole, dynamic control of the
regression of endometriosis foci was performed. All drugs were administered
orally daily for 24 weeks, after which a re-evaluation of the size of the
endometrioid implants was performed.
Results and Discussion.
At the randomization stage, the average diameters of endometrioid
implants were comparable in all groups. A comparative assessment of the
effectiveness of the drugs with the control group and a comparison between the
groups were carried out. The average area of endometrioid implants was
significantly lower in all treated groups compared with the control group
(p<0.05, Fischer's criterion).
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
87
The most pronounced reduction in the size of endometrioid implants was
observed in the group of women receiving dienogest. Dynamic monitoring
revealed a decrease in the size of foci in more than half of the examined – 54%,
no regression of foci was noted in 8% of patients. In the group of women who
were prescribed letrozole, regression of foci in terms of diameter reduction
parameters was observed in 48%. There was a significant reduction in the size
of endometrioid implants compared to the control group, with no statistically
significant difference between the groups.
Conclusion.
The study confirms the current lack of oral medications for the treatment of
endometriosis that are comparable in efficacy and safety to dienogest. It is
necessary to further study the various schemes for the use of non-hormonal
drugs as an adjunct to classical hormone-modulating therapy for endometriosis
or as monotherapy in patients with contraindications to standard hormonal
therapy.
References:
1.
Zondervan, KT; Becker, CM; Missmer, SA. Endometriosis.N. Engl. J. Med.
2020, 382, 1244–1256.
2.
Martire, F. G.; Constantini, E.; D'Abate, K.; Schettini, G.; Sorrenti, G.; Centini,
J.; Zupi, E.; Lazzeri, L. Endometriosis and adenomyosis: from pathogenesis to
observation. Course. Problems of Molecular Biology, 2025, 47, 298.
3.
Vercellini, P.; Bandini, V.; Vigano, P.; Ambruoso, D.; Cetera, G.E.; Somigliana,
E. A proposal for targeted, neoevolution-oriented secondary prevention of early
endometriosis and adenomyosis. Part II: Medical interventions. Part I: Medical
interventions. Hum. Reprod. 2024, 39, 1–17.
4.
Vercellini, P.; Bandini, V.; Vigano, P.; Ambruoso, D.; Cetera, G.E.; Somigliana,
E. A proposal for targeted, neoevolution-oriented secondary prevention of early
endometriosis and adenomyosis. Part II: Medical interventions. Hum. Reprod.
2024, 39, 18–34.
5.
Martire, FG; Giorgi, M.; D'abate, C.; Colombi, I.; Ginetti, A.; Cannoni, A.;
Fedele, F.; Exacoustos, C.; Centini, G.; Zupi, E. Deep infiltrative endometriosis in
adolescents: early diagnosis and possible prevention of disease progression. J.
Clin. Med. 2024, 13, 550.
6.
Sarria-Santamera A., Orazumbekova B., Terzic M. et al. Systematic review
and meta-analysis of incidence and prevalence of endometriosis. Healthcare
(Basel). 2020; 9(1): 29. DOI: 10.3390/ healthcare9010029
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
88
7.
Bougie O., Yap M.I., Sikora L. et al. Influence of race/ethnicity on
prevalence and presentation of endometriosis: a systematic review and meta-
analysis. BJOG. 2019; 126(9): 1104-15. DOI: 10.1111/1471-0528.15692
8.
Khine Y.M., Taniguchi F., Harada T. Clinical management of endometriosis-
associated infertility. Reprod. Med. Biol. 2016; 15(4): 217-25. DOI:
10.1007/s12522-016-0237-9
9.
Hwang H., Chung Y.-J., Lee S.R. et al. Clinical evaluation and management of
endometriosis: guideline for Korean patients from Korean Society of
Endometriosis. Obstet. Gynecol. Sci. 2018; 61(5): 553-64. DOI:
10.5468/ogs.2018.61.5.553
10.
Mettler L., Alkatout I., Keckstein J. et al., eds. Endometriosis: a concise
practical guide to current diagnosis and treatment. Endo Press GmbH; 2018. 480
p.
