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Erschienen in: Advances in Therapy 5/2017

28.03.2017 | Original Research

Comparing the Administration of Letrozole and Megestrol Acetate in the Treatment of Women with Simple Endometrial Hyperplasia without Atypia: A Randomized Clinical Trial

verfasst von: Sanam Moradan, Niaz Nikkhah, Majid Mirmohammadkhanai

Erschienen in: Advances in Therapy | Ausgabe 5/2017

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Abstract

Introduction

The present study was conducted as a pilot to compare the therapeutic effects and the potential side effects of oral Megestrol acetate and Letrozole in the treatment of simple hyperplasia in perimenopausal women.

Methods

The participants of this randomized clinical trial consisted of two groups of 25 women aged 44–50 presenting with abnormal uterine bleeding diagnosed with simple endometrial hyperplasia without cytologic atypia confirmed by transvaginal ultrasonography and biopsy. The first group received 40-mg doses of Megestrol acetate for 2 weeks per month for a total period of 2 months. The second group received 2.5-mg daily doses of Letrozole for a total period of 2 months. The differences in terms of quantitative measurements were analyzed using the independent two-sample t test and the paired t test. To compare the two groups in terms of the distribution of the categorical variables, Pearson’s Chi square and Fisher’s Exact tests were used at the significance level of 0.05 by Stata-9.2.

Results

Although the intervention led to significant improvements in both groups (P < .001), there was no difference between the groups in terms of accomplishing resolution (P = .74) [seven (28%) patients in the Letrozole group and five (20%) in the Megestrol group], while two patients in the Letrozole group and nine in the Megestrol group suffered from side effects, suggesting significantly lower side effects in the Letrozole group (P = .02).

Conclusion

Letrozole and Megestrol acetate seem to have similar effects on the treatment of simple endometrial hyperplasia, the only difference being that Letrozole presents fewer side effects than Megestrol acetate in patients with this condition.

Funding

Abnormal Uterine Bleeding Research Center of Semnan University of Medical Sciences, Semnan, Iran.
Trial Registration: IRCT2015031011504N5
Literatur
1.
Zurück zum Zitat Tasci Y, Polat OG, Ozdogan S, Karcaaltincaba D, Seckin L, Erkaya S. Comparison of the efficacy of micronized progesterone and lynestrenol in treatment of simple endometrial hyperplasia without atypia. Arch Gynecol Obstet. 2014;290(1):83–6.CrossRefPubMed Tasci Y, Polat OG, Ozdogan S, Karcaaltincaba D, Seckin L, Erkaya S. Comparison of the efficacy of micronized progesterone and lynestrenol in treatment of simple endometrial hyperplasia without atypia. Arch Gynecol Obstet. 2014;290(1):83–6.CrossRefPubMed
2.
Zurück zum Zitat Armstrong AJ, Hurd WW, Elguero S, Barker NM, Zanotti KM. Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol. 2012;19(5):562–71.CrossRefPubMed Armstrong AJ, Hurd WW, Elguero S, Barker NM, Zanotti KM. Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol. 2012;19(5):562–71.CrossRefPubMed
3.
Zurück zum Zitat Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004;59(5):368–78.CrossRefPubMed Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004;59(5):368–78.CrossRefPubMed
4.
Zurück zum Zitat Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia.A long-term study of “untreated” hyperplasia in 170 patients. Obstet Gynecol Surv. 1986;41(1):58–61.CrossRef Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia.A long-term study of “untreated” hyperplasia in 170 patients. Obstet Gynecol Surv. 1986;41(1):58–61.CrossRef
5.
6.
Zurück zum Zitat Haimovich S, Checa MA, Mancebo G, Fusté P, Carreras R. Treatment of endometrial hyperplasia without atypia in peri-and postmenopausal women with a levonorgestrel intrauterine device. Menopause. 2008;15(5):1002–7.CrossRefPubMed Haimovich S, Checa MA, Mancebo G, Fusté P, Carreras R. Treatment of endometrial hyperplasia without atypia in peri-and postmenopausal women with a levonorgestrel intrauterine device. Menopause. 2008;15(5):1002–7.CrossRefPubMed
7.
Zurück zum Zitat Crosignani P, Luciano A, Ray A, Bergqvist A. Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod. 2006;21(1):248–56.CrossRefPubMed Crosignani P, Luciano A, Ray A, Bergqvist A. Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod. 2006;21(1):248–56.CrossRefPubMed
8.
Zurück zum Zitat Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain. Fertil Steril. 2006;85(2):314–25.CrossRefPubMed Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain. Fertil Steril. 2006;85(2):314–25.CrossRefPubMed
9.
Zurück zum Zitat Ismail MT, Fahmy DM, Elshmaa NS. Efficacy of levonorgestrel-releasing intrauterine system versus oral progestins in treatment of simple endometrial hyperplasia without atypia. Reprod Sci. 2013;20(1):45–50.CrossRefPubMed Ismail MT, Fahmy DM, Elshmaa NS. Efficacy of levonorgestrel-releasing intrauterine system versus oral progestins in treatment of simple endometrial hyperplasia without atypia. Reprod Sci. 2013;20(1):45–50.CrossRefPubMed
10.
Zurück zum Zitat Amezcua CA, Lu JJ, Felix JC, Stanczyk FZ, Zheng W. Apoptosis may be an early event of progestin therapy for endometrial hyperplasia. Gynecol Oncol. 2000;79(2):169–76.CrossRefPubMed Amezcua CA, Lu JJ, Felix JC, Stanczyk FZ, Zheng W. Apoptosis may be an early event of progestin therapy for endometrial hyperplasia. Gynecol Oncol. 2000;79(2):169–76.CrossRefPubMed
11.
Zurück zum Zitat Ferenczy A, Gelfand M. The biologic significance of cytologic atypia in progestogen-treated endometrial hyperplasia. Am J Obstet Gynecol. 1989;160(1):126–31.CrossRefPubMed Ferenczy A, Gelfand M. The biologic significance of cytologic atypia in progestogen-treated endometrial hyperplasia. Am J Obstet Gynecol. 1989;160(1):126–31.CrossRefPubMed
12.
Zurück zum Zitat Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997;90(3):434–40.CrossRefPubMed Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997;90(3):434–40.CrossRefPubMed
13.
Zurück zum Zitat Moradan S, Omidvar V. Desogestrel + ethinylestradiol versus levonorgestrel + ethinylestradiol. Which one has better affect on acne, hirsutism, and weight change? Saudi medical journal. 2011;32(1):23–6. Moradan S, Omidvar V. Desogestrel + ethinylestradiol versus levonorgestrel + ethinylestradiol. Which one has better affect on acne, hirsutism, and weight change? Saudi medical journal. 2011;32(1):23–6.
14.
Zurück zum Zitat Li H, Chen X, Qiao J. Letrozole as primary therapy for endometrial hyperplasia in young women. Int J Gynecol Obstet. 2008;100(1):10–2.CrossRef Li H, Chen X, Qiao J. Letrozole as primary therapy for endometrial hyperplasia in young women. Int J Gynecol Obstet. 2008;100(1):10–2.CrossRef
15.
Zurück zum Zitat Gupta S. A Comprehensive Textbook of Obstetrics and Gynecology. Jaypee Brothers Medical Publishers. 2011; 1th Edition 268. Gupta S. A Comprehensive Textbook of Obstetrics and Gynecology. Jaypee Brothers Medical Publishers. 2011; 1th Edition 268.
16.
Zurück zum Zitat Wheeler DT, Bristow RE, Kurman RJ. Histologic alterations in endometrial hyperplasia and well- differentiated carcinoma treated with progestins. Am J Surg Pathol. 2007;31(7):988–98.CrossRefPubMed Wheeler DT, Bristow RE, Kurman RJ. Histologic alterations in endometrial hyperplasia and well- differentiated carcinoma treated with progestins. Am J Surg Pathol. 2007;31(7):988–98.CrossRefPubMed
17.
Zurück zum Zitat Tabatabaie A, Karimi ZM, Dehghani-Tafti M, Miratashi-Yazdi A, Teimoori S, Dehghani A. Comparing letrozole with medroxyprogesterone acetate (MPA) as hormonal therapy for simple endometrial hyperplasia without atypia in adult and middle-aged women. Eur J Gynaecol Oncol. 2012;34(6):552–5. Tabatabaie A, Karimi ZM, Dehghani-Tafti M, Miratashi-Yazdi A, Teimoori S, Dehghani A. Comparing letrozole with medroxyprogesterone acetate (MPA) as hormonal therapy for simple endometrial hyperplasia without atypia in adult and middle-aged women. Eur J Gynaecol Oncol. 2012;34(6):552–5.
18.
Zurück zum Zitat Lähteenmäki P, Rauramo I, Backman T. The levonorgestrel intrauterine system in contraception. Steroids. 2000;65(10):693–7.CrossRefPubMed Lähteenmäki P, Rauramo I, Backman T. The levonorgestrel intrauterine system in contraception. Steroids. 2000;65(10):693–7.CrossRefPubMed
19.
Zurück zum Zitat Barker L, Brand I, Crawford S. Sustained effect of the aromatase inhibitors anastrozole and letrozole on endometrial thickness in patients with endometrial hyperplasia and endometrial carcinoma. Curr Med Res Opin. 2009;25(5):1105–9.CrossRefPubMed Barker L, Brand I, Crawford S. Sustained effect of the aromatase inhibitors anastrozole and letrozole on endometrial thickness in patients with endometrial hyperplasia and endometrial carcinoma. Curr Med Res Opin. 2009;25(5):1105–9.CrossRefPubMed
20.
Zurück zum Zitat Espindola D, Kennedy KA, Fischer EG. Management of abnormal uterine bleeding and the pathology of endometrial hyperplasia. Obstet Gynecol Clin North Am. 2007;34(4):717–37.CrossRefPubMed Espindola D, Kennedy KA, Fischer EG. Management of abnormal uterine bleeding and the pathology of endometrial hyperplasia. Obstet Gynecol Clin North Am. 2007;34(4):717–37.CrossRefPubMed
21.
Metadaten
Titel
Comparing the Administration of Letrozole and Megestrol Acetate in the Treatment of Women with Simple Endometrial Hyperplasia without Atypia: A Randomized Clinical Trial
verfasst von
Sanam Moradan
Niaz Nikkhah
Majid Mirmohammadkhanai
Publikationsdatum
28.03.2017
Verlag
Springer Healthcare
Erschienen in
Advances in Therapy / Ausgabe 5/2017
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-017-0509-8

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