Efficacy and safety of nafarelin in the treatment of endometriosis

Article Abstract:

Endometriosis is a gynecological complication that develops when the cells that normally line the uterus, the endometrial cells, grow and function in other locations in the body. Nafarelin is a drug similar to gonadotropin-releasing hormone, which is released by glands in the brain (hypothalamus and pituitary) that stimulate the ovaries. Nafarelin initially increases estrogen production by the ovaries, followed by a decrease in production two weeks later. When the ovaries are stimulated, they release estrogen. Since endometrial cells respond to hormones produced by the ovaries, by inhibiting the production of estrogen, endometrial tissue cannot respond. When the drug is used long-term, menstruation stops and endometriosis is controlled. The safety and efficacy of nafarelin was compared to danazol, a male hormone (androgen) used to treat endometriosis. Laparoscopy, a surgical procedure where a tube affixed with a magnifying lens is inserted into a small opening in the abdomen to visualize internal structures, can confirm the presence of endometrial tissue in abnormal locations. Laparoscopy was performed before and after treatment with either nafarelin (400 micrograms) administered through the nose (204 patients), 800 micrograms of nafarelin a day (79 patients), danazol 600 mg a day (67 patients), or danazol 800 mg a day (80 patients). The most frequently experienced side effect of nafarelin therapy was hot flashes. A decrease in bone density, a known side effect of decreased estrogen, was reversible when nafarelin was discontinued. Side effects of danazol included weight gain, abnormal blood lipids and increased liver enzymes (an indicator of liver functioning). Nafarelin was equally effective in reducing symptoms of endometriosis with side effects that were different and more tolerable than those produced by danazol. Treatment caused symptoms of endometriosis to abate for up to six months after treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Nafarelin in the treatment of pelvic pain caused by endometriosis

Article Abstract:

Endometriosis is a gynecological complication that develops when the endometrial cells, which normally line the uterus, grow and function in other locations in the body. Although most patients with endometriosis complain of pelvic pain and pain during menstruation or sex, a few have no pain. Nafarelin is a drug similar to gonadotropin-releasing hormone, which is released by glands in the brain that stimulate the ovaries. Nafarelin initially increases estrogen production by the ovaries, followed by a decrease in production two weeks later. When the ovaries are stimulated, they release estrogen. Since endometrial cells respond to hormones produced by the ovaries, by inhibiting the production of estrogen, endometrial tissue cannot respond. Danazol is a male hormone (androgen), which also represses estrogen production. However, danazol has many intolerable side effects. The effectiveness of nafarelin therapy on reducing pain associated with endometriosis was compared with danazol. Women were given either nafarelin (200 micrograms twice a day), administered through a nose spray, or danazol (200 mg three times a day) for six months. Of the 73 out of 82 patients with endometriosis experiencing pelvic pain, 94 percent of the patients receiving nafarelin and 91 percent receiving danazol experienced improvement or resolution of pain. Nafarelin therapy produced a greater reduction of estrogen over danazol. Long-term studies are needed to establish the duration of pain relief. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pain

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Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin (Synarel)

Article Abstract:

A second treatment with nafarelin may effectively relieve symptoms of endometriosis without causing significant loss of bone density. Nafarelin is currently approved for a single 6-month treatment course for endometriosis, a cause of significant pelvic pain in some women. Researchers evaluated a second, 3-month course of nafarelin in 45 women with recurrent endometriosis. The drug significantly relieved the signs and symptoms of endometriosis. Spinal bone mineral density decreased an average of 2% during treatment, but returned to normal within 6 months after treatment.

Bones, Bone density

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