The Hormonal Profile of Norethindrone Acetate: Rationale for Add-Back Therapy With Gonadotropin-Releasing Hormone Agonists in Women With Endometriosis

@article{Chwalisz2012TheHP,
  title={The Hormonal Profile of Norethindrone Acetate: Rationale for Add-Back Therapy With Gonadotropin-Releasing Hormone Agonists in Women With Endometriosis},
  author={Kristof Chwalisz and Eric S. Surrey and Frank Z. Stanczyk},
  journal={Reproductive Sciences},
  year={2012},
  volume={19},
  pages={563 - 571}
}
Gonadotropin-releasing hormone agonists (GnRHa) are an effective treatment of endometriosis-associated pelvic pain. The use of hormonal add-back therapy can alleviate the hypoestrogenic symptoms associated with GnRHa therapy, while preserving therapeutic efficacy. Norethindrone acetate (NETA) is a unique progestin that has both estrogenic and androgenic properties and is effective as an add-back regimen without estrogen supplementation. Through its estrogenic activity, NETA exerts beneficial… Expand
Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis
TLDR
A narrative review aims to give an overview of the safety and tolerability of GnRH-a therapy and to present the different options of steroidal and non-steroidal add-back therapies in order to reduce the hypoestrogenic side effects. Expand
Treatment of Endometriosis with the GnRHa Deslorelin and Add-Back Estradiol and Supplementary Testosterone
TLDR
Daily intranasal D with low dose E2  ± T add-back resulted in significant reduction in severity of endometriosis symptoms and signs with few safety signals and minimal hypoestrogenic symptoms that would be expected with the use of a GnRHa alone. Expand
Analysis of Adherence, Persistence, and Surgery Among Endometriosis Patients Treated with Leuprolide Acetate Plus Norethindrone Acetate Add-Back Therapy.
TLDR
To compare adherence to and persistence with LA treatment and time to endometriosis-related surgery among women treated with NETA and womentreated with LA plus other add-back therapies or LA only, a retrospective analysis was conducted using Truven Health MarketScan Commercial Claims and Encounters Database. Expand
Estrogen-progestins and progestins for the management of endometriosis.
TLDR
Estrogen-progestins and progestins reduce the incidence of postoperative endometricrioma recurrence and show a protective effect against endometriosis-associated epithelial ovarian cancer risk. Expand
Advances in pharmacotherapy for treating endometriosis
TLDR
The treatments most recently proposed for endometriosis will be described in detail, including gonadotropin-releasing hormone (GnRH) antagonists, aromatase inhibitors (AIs) and the flexible extended combined oral contraceptive. Expand
Elagolix, a Novel, Orally Bioavailable GnRH Antagonist under Investigation for the Treatment of Endometriosis-Related Pain
TLDR
Elagolix is the frontrunner among an emerging class of GnRH antagonists, which unlike their peptide predecessors has a nonpeptide structure resulting in its oral bioavailability and may become a valuable addition to the armamentarium of pharmacological agents to treat endometriosis-related pain. Expand
Oral and depot progestin therapy for endometriosis: towards a personalized medicine
TLDR
Progestins are effective in controlling pain symptoms in the majority of women with endometriosis, and their effect seems not inferior to that achieved with other compounds used to treat the disease, such as gonadotropin-releasing hormone agonist. Expand
Short- and long-term impact of gonadotropin-releasing hormone analogue treatment on bone loss and fracture.
TLDR
The impact of GnRH analogues on both bone loss and fracture risk as well as describe different add-back regimens are explored. Expand
Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review
TLDR
There is a place for GnRH antagonists in the management of symptomatic endometriosis and clinical trials should be conducted, taking into account the different phenotypes in order to propose novel algorithms. Expand
Current understanding on pharmacokinetics, clinical efficacy and safety of progestins for treating pain associated to endometriosis
TLDR
This review aims to offer the reader a complete overview of pharmacokinetic (PK) and clinical efficacy of progestins for the treatment of endometriosis. Expand
...
1
2
3
4
...

References

SHOWING 1-10 OF 90 REFERENCES
Gonadotropin-releasing hormone agonist and add-back therapy: what do the data show?
  • E. Surrey
  • Medicine
  • Current opinion in obstetrics & gynecology
  • 2010
Purpose of review Endometriosis is a gynecologic disorder that can lead to debilitating chronic pelvic pain and infertility. Gonadotropin-releasing hormone agonists (GnRHa) have emerged as a primaryExpand
The role of add-back therapy in the United States.
TLDR
Add-back therapy with a progestin or a progESTin plus low-dose estrogen helps to reduce the side effects associated with GnRH agonist administration without compromising efficacy. Expand
Add-back therapy use and its impact on LA persistence in patients with endometriosis
TLDR
Patients with endometriosis taking the GnRH-a leuprolide acetate (LA) depot suspension were most likely to continue therapy longer and have greater compliance compared with the older age group cohorts, and these patients had significantly higher persistence and compliance with LA therapy compared to no ABT user group. Expand
Add-back therapy and gonadotropin-releasing hormone agonists in the treatment of patients with endometriosis: can a consensus be reached? Add-Back Consensus Working Group.
TLDR
In patients with symptomatic endometriosis, the efficacy of GnRH agonists may be preserved and therapy prolonged while overcoming hypoestrogenic side effects with the use of appropriate add-back regimens. Expand
Prolonged use of gonadotropin-releasing hormone agonist and tibolone as add-back therapy for the treatment of endometrial hyperplasia.
TLDR
It seems that the combined GnRH-a/tibolone treatment in women with EH is a potent alternative, so far as the endometrial status and the clinical course of the disease are concerned, whereas tibol one appears to act sufficiently as add-back therapy to prolonged GnRH -a treatment. Expand
Hormone treatment of endometriosis: the estrogen threshold hypothesis.
  • R. Barbieri
  • Medicine
  • American journal of obstetrics and gynecology
  • 1992
TLDR
Differences in organ response to estradiol may allow the design of regimens with a gonadotropin-releasing hormone agonist that maintain a therapeutic response and ameliorate potential adverse effects. Expand
Leuprolide Acetate Depot and Hormonal Add‐Back in Endometriosis: A 12‐Month Study
TLDR
The use of leuprolide acetate depot in combination with norethindrone acetate 5 mg alone, or with noredouble acetate and conjugated equine estrogens 0.625 mg, provides effective suppression of pelvic pain symptoms associated with endometriosis while protecting against bone loss. Expand
One year comparison between two add-back therapies in patients treated with a GnRH agonist for symptomatic endometriosis: a randomized double-blind trial.
TLDR
Estradiol 2 mg and promegestone 0.5 mg per day is an effective and safe add-back therapy, which can be proposed for prolonged leuprorelin treatment over 6 months in severe endometriosis. Expand
Advances in the management of endometriosis: an update for clinicians.
TLDR
Management of endometriosis focuses on pain relief and includes medical and surgical treatment, and newer options for treatment include depot medroxyprogesterone acetate subcutaneous injection, as well as several agents under investigation that may prove to have therapeutic potential. Expand
Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women.
TLDR
Combination estrogen/transvaginal progesterone gel increases exercise time to myocardial ischemia, as compared with estrogen/MPA, which implies that the choice of progestin in women at higher cardiovascular risk requires careful consideration. Expand
...
1
2
3
4
5
...