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Kilpatrick RD, Chiuve SE, Leslie WD, Wegrzyn LR, Gao W, Yang H, Soliman AM, Snabes MC, Koenigsberg S, Zhong J, Xiang C, Watts NB. Estimating the Effect of Elagolix Treatment for Endometriosis on Postmenopausal Bone Outcomes: A Model Bridging Phase III Trials to an Older Real-World Population. JBMR Plus 2020; 4:e10401. [PMID: 33354641 PMCID: PMC7745882 DOI: 10.1002/jbm4.10401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 01/23/2023] Open
Abstract
Elagolix, a gonadotrophin‐releasing hormone antagonist, is used in premenopausal women with endometriosis. There is a risk of bone loss with elagolix, but the long‐term effects of BMD loss later in life cannot be directly assessed and has not been quantified. To address this gap in knowledge, this study indirectly estimated the impact of elagolix on postmenopausal fracture risk. BMD change in premenopausal women with endometriosis treated with elagolix was modeled from the phase III program data (elagolix group) and used to simulate treatment effects on (fracture risk assessment tool estimated) 10‐year risks of hip and major osteoporotic fracture in women ages 50 to 79 years from the 2005–2010 National Health and Nutrition Examination Survey (NHANES; N = 2303). Change in the proportion of women reaching risk‐based antiosteoporotic treatment thresholds was also estimated. For elagolix versus NHANES, median 10‐year risk of major osteoporotic fracture was 4.73% versus 4.70% in women ages 50 to 59 years, 7.03% versus 6.97% in women ages 60 to 69 years, and 10.83% versus 10.68% in women ages 70 to 79 years. Median 10‐year risk of hip fracture in these same groups was 0.19% versus 0.18% for women ages 50 to 59 years, 0.51% versus 0.49% for women 60 to 69 years, and 2.22% versus 2.14% for women 70 to 79 years. The proportion of women reaching risk‐based antiosteoporotic treatment thresholds caused by elagolix 150 mg daily for 12 months was 0.36% higher at age 50 to 59 years, 0.23% at age 60 to 69 years, and 1.79% at age 70 to 79 years. The number needed to harm was 643 for one additional hip fracture and 454 for one additional major osteoporotic fracture. Results were similar for elagolix 200 mg twice a day for 3 months. In the modeled scenarios, elagolix had minimal impact on long‐term risk of fracture and reaching risk‐based treatment thresholds. © 2020 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Ryan D Kilpatrick
- Global Epidemiology, Pharmacovigilance & Patient Safety, AbbVie, Inc. Chicago IL USA
| | - Stephanie E Chiuve
- Global Epidemiology, Pharmacovigilance & Patient Safety, AbbVie, Inc. Chicago IL USA
| | | | - Lani R Wegrzyn
- Global Epidemiology, Pharmacovigilance & Patient Safety, AbbVie, Inc. Chicago IL USA
| | - Wei Gao
- Analysis Group, Inc. Boston MA USA
| | | | - Ahmed M Soliman
- Health Economics and Outcomes Research, AbbVie, Inc. Chicago IL USA
| | - Michael C Snabes
- Clinical Development, Global Pharmaceutical Research and Development, AbbVie, Inc Chicago IL USA
| | | | | | | | - Nelson B Watts
- Mercy Health Osteoporosis and Bone Health Services Cincinnati OH USA
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Rozenberg S, Antoine C, Vandromme J, Fastrez M. Should we abstain from treating women with endometriosis using menopausal hormone therapy, for fear of an increased ovarian cancer risk? Climacteric 2015; 18:448-52. [PMID: 25958744 DOI: 10.3109/13697137.2015.1041905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Women suffering from endometriosis often have an early menopause, resulting in severe menopausal symptoms and an increased risk of osteoporosis. They are therefore candidates for menopausal hormone therapy (MHT). Unfortunately, MHT may increase the risk of endometriosis recurrence. Moreover, endometriosis patients are at increased risk of ovarian cancer, which may be further enhanced by MHT use. It is unknown, however, whether MHT more frequently increases type I (low-grade serous tumors), which seem to be increased when endometriosis is present, or type II (the more aggressive high-grade serous) tumors. We propose the following decision-making algorithm for endometriosis patients considering MHT. Those who have been treated with bilateral salpingo-oophorectomy, and in whom there is no residual endometriotic disease, can probably be treated using MHT without risk of endometriosis recurrence or fear of ovarian cancer. For women with significant, residual endometriosis lesions, the benefit may outweigh the risks, when menopause is reached before the age of 45 years or when severe symptoms are present.
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Affiliation(s)
- S Rozenberg
- Department of Obstetrics and Gynecology, CHU Saint-Pierre, Université Libre de Bruxelles, Vrije Universiteit Brussel , Brussels , Belgium
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MEIGS JV. Endometriosis. Trans South Surg Assoc 2008; 59 (1 vol.):44-58. [PMID: 18105741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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VON NUMERS. OBSERVATIONS ON METAPLASTIC CHANGES IN THE GERMINAL EPITHELIUM OF THE OVARY AND ON THE AETIOLOGY OF OVARIAN ENDOMETRIOSIS. Acta Obstet Gynecol Scand 1965; 44:107-16. [PMID: 14299344 DOI: 10.3109/00016346509153982] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
The histological patterns exhibited in the endometrium due to the newer progestational agents cannot be correlated with the patient's menstrual cycle or the physiological endometrium which follows ovulation. The oral progestational agents which have been produced during the past few years have had wide clinical application. Although the 19-nor-steroids and the derivatives of 17 alphahydroxyprogesterone differ in chemical structure, they produce similar histological appearances in the endometrium. Prolonged use of these compounds produces atrophy of the endometrial glands and a cellular stroma which might be mistaken for endometrial sarcoma. In view of the fact that such compounds are widely used in clinical practice and as contraceptive agents, it is essential that the pathologist should be aware of the bizarre endometrial patterns which they may produce; the more important of these changes are illustrated and discussed.
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CROWSON LB, WINER BA, NOYES RW. EVALUATION OF A NEW PROGESTIN. Obstet Gynecol 1965; 26:349-55. [PMID: 14341200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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KOSS LG, SPIRO RH, BRUNSCHWIG A. ENDOMETRIAL STROMAL SARCOMA. Surg Gynecol Obstet 1965; 121:531-7. [PMID: 14332889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HARRIS SI, WACHEN HL. CULLEN'S SIGN AND ENDOMETRIOSIS. Obstet Gynecol 1965; 26:327-32. [PMID: 14341196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BOAKE WC, SCHADE SG, MORRISSEY JF, SCHAFFNER F. INTRAHEPATIC CHOLESTATIC JAUNDICE OF PREGNANCY FOLLOWED BY ENOVID-INDUCED CHOLESTATIC JAUNDICE: REPORT OF A CASE. Ann Intern Med 1965; 63:302-8. [PMID: 14318470 DOI: 10.7326/0003-4819-63-2-302] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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PRATT JH. ENDOMETRIOSIS. CONSERVATIVE SURGICAL TREATMENT AND BOWEL COMPLICATIONS. Tex State J Med 1965; 61:596-601. [PMID: 14338559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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RENE L, SUREAU C, GOUYGOU C, QUEREL F. [AN UNUSUAL COMPLICATION OF ENDOMETRIOSIS: DEGENERATION]. Presse Med (1893) 1965; 73:1803-8. [PMID: 14301627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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ROSNER E. STROMAL ENDOMETRIOSIS. REVIEW OF THE PROBLEM AND CASE PRESENTATION. Med Times 1965; 93:675-7. [PMID: 14287376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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COHEN AM. [HORMONAL TREATMENT OF ENDOMETRIOSIS]. Ned Tijdschr Geneeskd 1965; 109:1027-31. [PMID: 14341481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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GUIOT G, LEVY J, AUQUIER L, COMOY C. [SCIATICA CAUSED BY ENDOMETRIOSIS (CATAMENIAL SCIATICA)]. Presse Med (1893) 1965; 73:1397-8. [PMID: 14301624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DEAVER JM, MYERS RN. USUAL AND UNUSUAL SURGICAL LESIONS OF THE COLON. Am J Gastroenterol 1965; 43:449-67. [PMID: 14287807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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KLINGES KG, WILBANKS GD, COLE GR. INJURY TO THE FEMORAL NERVE DURING PELVIC OPERATION. REPORT OF 3 CASES. Obstet Gynecol 1965; 25:619-23. [PMID: 14289522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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ISRAEL SL. THE PERSISTENT CHALLENGE OF HYSTERECTOMY. South Med J 1965; 58:608-11. [PMID: 14280784 DOI: 10.1097/00007611-196505000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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LAM SJ. PELVIC ENDOMETRIOSIS WITH IRREDUCIBLE FEMORAL HERNIA. Br Med J 1965; 1:1126. [PMID: 14270178 PMCID: PMC2165505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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KOLETA F. [CERVICAL PREGNANCY AS THE COMBINED RESULT OF BELATED FERTILIZATION AND A DISEASED UTERINE CERVIX?]. Zentralbl Gynakol 1965; 87:576-81. [PMID: 14346680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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SOBANSKI A. [ADENOMATOSIS OF THE LARGE INTESTINE]. Wiad Lek 1965; 18:655-9. [PMID: 14343063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HANWKINS DF. ADENOCARCINOMA ARISING IN A ADENOMYOMA. Proc R Soc Med 1965; 58:237-8. [PMID: 14263726 PMCID: PMC1898389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BERTHELSEN HG, BANG HO. THE EXCRETION OF PREGNANEDIOL DURING GESTAGEN TREATMENT OF ENDOMETRIOSIS. Dan Med Bull 1965; 12:32-4. [PMID: 14298389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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KAWASAKI DM. URETERAL OBSTRUCTION DUE TO ENDOMETRIOSIS; REPORT OF A CASE. Obstet Gynecol 1965; 25:579-81. [PMID: 14268050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HERTZ, BLOCH-LAINE, BONNET, TEXIER. [A RARE LOCALIZATION OF ENDOMETRIOSIS AND ITS DIAGNOSTIC DIFFICULTIES]. Bull Mem Soc Chir Paris 1965; 55:100-3. [PMID: 14341634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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MACH S. [PERINEAL ENDOMETRIOSIS FOLLOWING PERINEAL RUPTURE AND EPISIOTOMY]. Zentralbl Gynakol 1965; 87:346-50. [PMID: 14288868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HASSERJIAN HK, DOROUGH ME. ENDOMETRIOSIS. THE DISEASE AS SEEN AT A PRIVATE TEACHING HOSPITAL. Pac Med Surg 1965; 73:137-43. [PMID: 14266028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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