Relugolix, an oral gonadotropin-releasing hormone receptor antagonist, reduces endometriosis-associated pain in a dose–response manner: a randomized, double-blind, placebo-controlled study
Once-daily oral relugolix, a gonadotropin-releasing hormone receptor antagonist, was well tolerated and effective in a dose–response manner over 12 weeks for the treatment of endometriosis-associated pain in premenopausal women.
Published
VOLUME 115, ISSUE 2, P397-405
Authors:
Yutaka Osuga, M.D., Ph.D., Yoshifumi Seki, M.Sc., Masataka Tanimoto, B.Pharm.,
Takeru Kusumoto, M.Sc., Kentarou Kudou, M.Sc., and Naoki Terakawa, M.D., Ph.D.
Abstract:
Objective
To evaluate the efficacy and safety of three dose levels of relugolix, a gonadotropin-releasing hormone receptor antagonist, compared with placebo and leuprorelin in women with endometriosis-associated pain.
Design
Phase 2, multicenter, randomized, double-blind, placebo-controlled study.
Setting
Hospitals and clinics.
Patient(s)
Adult premenopausal women with endometriosis who had dysmenorrhea and endometriosis-associated pelvic pain.
Intervention(s)
During a 12-week treatment period, patients received relugolix 10 mg (n = 103), 20 mg (n = 100), or 40 mg (n = 103) as a daily oral dose; placebo (n = 97) as a daily oral dose; or leuprorelin 3.75 mg (n = 80) as a monthly subcutaneous injection.
Main Outcome Measure(s)
Primary endpoint was the change from baseline in mean visual analog scale score for pelvic pain during 28 days before the end of treatment.
Result(s)
The mean changes in mean visual analog scale score for pelvic pain were –3.8 mm in the placebo group; –6.2, –8.1, and –10.4 mm in the relugolix 10-mg, 20-mg, and 40-mg groups; respectively; and –10.6 mm in the leuprorelin group. The major adverse events with relugolix were hot flush, metrorrhagia, menorrhagia, and irregular menstruation, and bone mineral density decrease in a dose–response manner, which were also observed in the leuprorelin group with a frequency comparable with that in the relugolix 40-mg group.
Conclusion(s)
Oral administration of relugolix alleviated endometriosis-associated pain in a dose–response manner and was generally well tolerated. Relugolix 40 mg demonstrated efficacy and safety comparable with those of leuprorelin.
Clinical Trial Registration Number
NCT01458301.
Comments
I am part of a team currently working on a cochrane review on the benefits of GnRH antagonists as a treatment for endometriotic pain. This trial has been selected for the meta-analysis. Following discussions with our statistician we would like to ask the authors whether they could provide us with final scores (as appose to the change from baseline published in the paper) for pelvic pain, dysmenorrhoea and and dyspareunia. This would help us enormously with the data analysis in the final meta-analysis. Thank you