Abstract：
OBJECTIVE: The objective of this work is to evaluate the place of new treatments in the management of endometriosis outside the context of infertility.
METHODS: A review of the literature was conducted by consulting Medline data until July 2017.
RESULTS: Dienogest is effective compared to placebo in short term (NP2) and long term (NP4) for the treatment of painful endometriosis. In comparison with GnRH agonists, dienogest is also effective in terms of decreased pain and improved quality of life in non-operated patients (NP2) as well as for recurrence of lesions and symptomatology postoperatively (NP2). Data on GnRH antagonists, selective progesterone receptor modulators as well as selective inhibitors (anti-TNF-α, matrix metalloprotease inhibitors, angiogenesis growth factor inhibitors) are insufficient to provide evidence of interest in clinical practice for the management of painful endometriosis (NP3).
CONCLUSIONS: Dienogest is recommended as second-line therapy for the management of painful endometriosis (Grade B). Because of lack of evidence, aromatase inhibitors, elagolix, SERM, SPRM and anti-TNF-α are not recommended for the management of painful endometriosis (Grade C).
METHODS: A review of the literature was conducted by consulting Medline data until July 2017.
RESULTS: Dienogest is effective compared to placebo in short term (NP2) and long term (NP4) for the treatment of painful endometriosis. In comparison with GnRH agonists, dienogest is also effective in terms of decreased pain and improved quality of life in non-operated patients (NP2) as well as for recurrence of lesions and symptomatology postoperatively (NP2). Data on GnRH antagonists, selective progesterone receptor modulators as well as selective inhibitors (anti-TNF-α, matrix metalloprotease inhibitors, angiogenesis growth factor inhibitors) are insufficient to provide evidence of interest in clinical practice for the management of painful endometriosis (NP3).
CONCLUSIONS: Dienogest is recommended as second-line therapy for the management of painful endometriosis (Grade B). Because of lack of evidence, aromatase inhibitors, elagolix, SERM, SPRM and anti-TNF-α are not recommended for the management of painful endometriosis (Grade C).
摘要：
目的：这项工作的目的是评估不孕症以外的子宫内膜异位症治疗中新疗法的位置。
方法：通过查阅Medline数据对文献进行回顾，直至2017年7月。
结果：与安慰剂相比，Dienogest在短期（NP2）和长期（NP4）治疗疼痛性子宫内膜异位症方面有效。与GnRH激动剂相比，在非手术患者（NP2）以及术后病变复发和症状学（NP2）方面，dienogest也有效。关于GnRH拮抗剂的数据，选择性孕激素受体调节剂以及选择性抑制剂(抗TNF-α，基质金属蛋白酶抑制剂，血管生成生长因子抑制剂）不足以在临床实践中提供治疗疼痛性子宫内膜异位症（NP3）的兴趣证据。
结论：Dienogest被推荐作为治疗疼痛性子宫内膜异位症的二线治疗（B级）。因为缺乏证据,芳香化酶抑制剂，elagolix,SERM,SPRM和抗TNF-α不推荐用于治疗疼痛性子宫内膜异位症（C级）。
方法：通过查阅Medline数据对文献进行回顾，直至2017年7月。
结果：与安慰剂相比，Dienogest在短期（NP2）和长期（NP4）治疗疼痛性子宫内膜异位症方面有效。与GnRH激动剂相比，在非手术患者（NP2）以及术后病变复发和症状学（NP2）方面，dienogest也有效。关于GnRH拮抗剂的数据，选择性孕激素受体调节剂以及选择性抑制剂(抗TNF-α，基质金属蛋白酶抑制剂，血管生成生长因子抑制剂）不足以在临床实践中提供治疗疼痛性子宫内膜异位症（NP3）的兴趣证据。
结论：Dienogest被推荐作为治疗疼痛性子宫内膜异位症的二线治疗（B级）。因为缺乏证据,芳香化酶抑制剂，elagolix,SERM,SPRM和抗TNF-α不推荐用于治疗疼痛性子宫内膜异位症（C级）。
