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M
arqui
ABT
514
R
ev
A
ssoc
M
ed
B
ras
2015; 61(6):507-518
TABLE 3
(Cont.) Main results of 17 studies that evaluated the effect of drugs on pain scores.
Study
Sample
Medication
used
Number of patients
treated
Information regarding pain
(instrument used, types of
pain, etc.)
Main results and/or conclusion
Ferrari et al.
27
26 women
with
colorectal
endometriosis
Continuous
oral contra-
ceptives
26 patients on continuous oral
contraceptives
VAS (dysmenorrhea, non-men-
strual pelvic pain, dyspareunia
and dyschezia with pain scores
measured before and 12 months
after administration of the drug)
The symptoms evaluated and their scores before and after treatment were:
dysmenorrhea (90.4±9.9
versus
26.9±29.2), non-menstrual pelvic pain
(65.0±27.3
versus
18.5±19.1), dyspareunia (63.1±22.8
versus
18.5±24.3) and
pain on defecation (57.7±28.2
versus
13.1±17.6). The values are expressed as
mean ± standard deviation and show that there was a significant decline in
intensity of symptoms after 12 months of treatment (p<0.01). At the end of
the study, 69% of patients were satisfied with the treatment. The following
adverse effects were noted: 38% uterine bleeding, 23% moderate weight gain,
11% headache and 7% decreased libido, although none of the women dis-
continued treatment due to the effects.
Petraglia
et al.
28
168 women
with
endometriosis
Dienogest
Initial sample: 168
Final sample: 152
VAS (CPP – 65 weeks, that is, 53
weeks in the group treated with
dienogest and 12 weeks in the
placebo group)
The mean VAS score was significantly reduced by 43.2 mm (standard devia-
tion ± 21.7) in the total period of 65 weeks of treatment (that is, the study
group
versus
placebo group, p<0.001), meaning that a significant decrease
pelvic pain was observed during continuous treatment with dienogest
(p<0.001). Adverse effects related to medication were noted in 27/168 pa-
tients (16.1%) during the study, with the intensity of adverse events related
to treatment ranging from mild to moderate in the majority of cases (92.5%).
Only 4 patients (2.4%) discontinued treatment due to side effects. Long term
treatment with dienogest was effective and the reduction of pelvic pain per-
sisted for at least 24 weeks after the end of treatment.
Giugliano
et al.
31
47 patients
with
endometriosis
N-palmitoy-
lethanol-
amide
Trans-polyda-
tin
47 patients divided into two groups ac-
cording to the ED site
19 – Group A (ED of the rectovaginal
septum)
28 – Group B (ED of the ovary)
VAS (dyspareunia, dyschezia,
dysmenorrhea and CPP) before,
1, 2 and 3 months after treat-
ment
Endometriotic pain intensity decreased significantly in both groups (p<0.0001).
The efficacy of treatment was significant after 30 days. Pain intensity also de-
creased in both groups, except for dysmenorrhea, which was reduced faster in
group B. The combination of N-palmitoylethanolamide and trans-polydatin re-
duced pain related to endometriosis, regardless of the site affected.
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