OBJECTIVE: To compare the effectiveness of LNG-IUS and dienogest for the management of adenomyosis, and explore the risk of occurrence of known side effects for both treatments.
METHODS: Systematic review and meta-analysis exploring the effectiveness of LNG-IUS and dienogest for the management of adenomyosis.
METHODS: A literature search was conducted using PICO guidelines and EMBASE, PubMed/MEDLINE, Scopus and Web of Science databases. Only clinical trials were collected and analysed.
RESULTS: Of the 792 studies that were initially identified, six were eligible for inclusion in this study. The studies included a total of 707 women; of these, 270 were treated with LNG-IUS, 354 were treated with dienogest, and 83 were controls. All the studies were from Asia (Bangladesh n = 1, China n = 2, India n = 1, Japan n = 1, South Korea n = 1). Dienogest was found to reduce pelvic pain significantly, evidenced by a lower visual analogue scale score, compared with LNG-IUS. Also, dienogest led to a significant reduction in uterine volume compared with LNG-IUS. However, subjects in the LNG-IUS group had significantly higher levels of haemoglobin than those in the dienogest group. Nonetheless, the occurrence of side effects such as weight gain, breast tenderness/distension, headache, insomnia/sleep disorder, depression/mood disorder, skin disorder/acne, and coital discomfort/reduced libido were comparable in both treatment groups.
CONCLUSIONS: Dienogest may be more effective than LNG-IUS for the management of adenomyosis, as it shows a superior effect in the reduction of pelvic pain and uterine volume. As only six studies were included in the present meta-analysis due to the paucity of data in the literature, it is recommended that well-designed randomized controlled trials comparing the effectiveness of dienogest with LNG-IUS should be conducted.
目的:为了比较LNG-IUS和Dienogest治疗子宫腺肌病的有效性,并探讨两种治疗方法发生已知副作用的风险。
方法:系统评价和荟萃分析探讨LNG-IUS和dienogest治疗子宫腺肌病的有效性。
方法:使用PICO指南和EMBASE进行了文献检索,PubMed/MEDLINE,Scopus和WebofScience数据库。仅收集和分析临床试验。
结果:在最初确定的792项研究中,6人符合纳入本研究的条件.这些研究共包括707名女性;其中,270用LNG-IUS处理,354人接受了Dienogest治疗,83个是对照组。所有研究均来自亚洲(孟加拉国n=1,中国n=2,印度n=1,日本n=1,韩国n=1)。发现Dienogest可显着减少骨盆疼痛,由较低的视觉模拟量表评分证明,与LNG-IUS相比。此外,与LNG-IUS相比,dienogest导致子宫体积显着减少。然而,LNG-IUS组受试者的血红蛋白水平显著高于denogest组.尽管如此,副作用的发生,如体重增加,乳房压痛/扩张,头痛,失眠/睡眠障碍,抑郁症/情绪障碍,皮肤病/痤疮,和性交不适/性欲降低在两个治疗组中具有可比性。
结论:在子宫腺肌病的治疗中,Dienogest可能比LNG-IUS更有效,因为它在减少盆腔疼痛和子宫体积方面显示出优异的效果。由于文献中缺乏数据,目前的荟萃分析中只包括了六项研究,建议进行精心设计的随机对照试验,比较dienogest和LNG-IUS的有效性.