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  • Relapse risk of endometrial hyperplasia after treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens.

Relapse risk of endometrial hyperplasia after treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens.

BJOG : an international journal of obstetrics and gynaecology (2015-12-03)
A Ørbo, M Arnes, A B Vereide, B Straume
ABSTRACT

To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia who were randomised to either a levonorgestrel-impregnated intrauterine system (LNG-IUS; Mirena(®) ) or two regimens of oral medroxyprogesterone acetate (MPA) after primary histological response. A multicentre randomised trial. Ten different outpatient clinics localised in hospitals and seven gynaecological private practices in Norway. One hundred and fifty-three women aged 30-70 years with low- or medium-risk endometrial hyperplasia met the inclusion criteria, and 153 completed the therapy. Patients were randomly assigned to one of the following three treatment arms: LNG-IUS; 10 mg of oral MPA administered for 10 days per cycle for 6 months; or 10 mg of oral MPA administered daily for 6 months. The women were followed for 24 months after ending therapy. Histological relapse of endometrial hyperplasia. Histological relapse was observed in 55/135 (41%) women who had an initial complete treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In the multivariable analyses relapse was dependent on menopausal status (P = 0.0005) and estrogen level (P = 0.0007). The risk of histological relapse of non-atypical endometrial hyperplasia is high within 24 months of ceasing therapy with either the LNG-IUS or oral MPA. Continued endometrial surveillance and prolonging progestogen therapy should be considered. Relapse of endometrial hyperplasia after successful treatment is independent of therapy regime.

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ORBO 609 Amberlite XAD®-2 (20/50) 400/200 mg, W,W,W separators, O.D. × L 8 mm × 110 mm, pkg of 50 ea
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ORBO 402 Tenax® TA specially treated (35/60), 100/50 mg, W,W,W separators, O.D. × L 8 mm × 100 mm, pkg of 50 ea
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ORBO 80 Coated Filter, with cassettes unassembled
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ORBO 554 H2SO4 on Silica Gel (20/40) 150/75 mg, W,W,W separators, O.D. × L 6 mm × 75 mm, pkg of 50 ea
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ORBO 23 2-HMP on Amberlite XAD®-2 (20/40), 120/60 mg, W,W,W separators, O.D. × L 6 mm × 85 mm, pkg of 25 ea
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ORBO 502 Activated Silica Gel (20/45) 100/50 mg, W,W,F separators, O.D. × L 6 mm × 75 mm, pkg of 50 ea
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ORBO 52 Small Activated Silica Gel (20/40) 150/75 mg, pk 50, W,W,F separators, O.D. × L 6 mm × 75 mm, pkg of 50 ea
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ORBO 43 Supelpak-20 specially treated Amberlite XAD®-2 (20/40), 100/50 mg, W,W,W (specially treated) separators, O.D. × L 8 mm × 100 mm, pkg of 50 ea
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