nafarelin and Abdominal-Pain

To review the efficacy and safety of nafarelin in the treatment of leiomyomas.. A literature review of published clinical trials was conducted. Six studies, including a total of 602 patients with leiomyomas, were reviewed. Patients received intranasal nafarelin, 50-400 micrograms twice daily for three to six months. Vaginal bleeding patterns, leiomyoma and uterine size, surgical conditions and adverse effects were assessed.. Nafarelin consistently suppressed estrogen production, reduced leiomyoma and uterine size, and controlled menorrhagia. The significant reduction in uterine bleeding and amenorrhea resulting from administration of nafarelin was associated with a rise in mean hemoglobin concentrations. In addition, nafarelin improved hematologic parameters in women with and without anemia. Nafarelin was well tolerated, although hot flushes were the most commonly reported adverse events. Measured bone mineral density decreased significantly during treatment, although by six to nine months post-treatment, it increased to values not significantly different from baseline. The adverse effects of nafarelin were generally reversible after treatment withdrawal.. Nafarelin treatment of women with symptomatic leiomyomas effectively decreases uterine bleeding; improves hematologic parameters; manages symptoms of menometrorrhagia, dysmenorrhea and pelvic discomfort; reduces uterine and myoma size; and is well tolerated. Reduction in bone mineral density occurs, but levels return to, or near, baseline levels within six months after treatment.

Topics: Abdominal Pain; Clinical Trials as Topic; Female; Hormones; Humans; Leiomyoma; Menorrhagia; Nafarelin; Pregnancy; Uterine Neoplasms

We evaluated the results of united treatment (thermocoagulation and nafarelin acetate) of the node type of endometriosis) among women with pain syndrome in pelvis minoris. During the treatment we observed withdrawal of pain in lower abdomen among 60% of patients and assuagement in remaining cases. During the treatment by Synarel the menses were absent together with complaints connected with menstruation. The efficacy of the drug together with surgical intervention was many times higher then that of thermocoagulation alone.

Topics: Abdominal Pain; Adult; Electrocoagulation; Endometriosis; Female; Hormones; Humans; Nafarelin; Pain Measurement; Pelvic Inflammatory Disease

Topics: Abdominal Pain; Danazol; Diagnosis, Differential; Dysmenorrhea; Endometriosis; Estrogen Antagonists; Female; Gonadotropin-Releasing Hormone; Goserelin; Humans; Hysterectomy; Laparoscopy; Leuprolide; Menorrhagia; Nafarelin; Nursing Assessment; Physical Examination; Progesterone; Severity of Illness Index

Twenty-five women with regular menstruation and laparoscopically confirmed endometriosis received 100 mcg nafarelin intranasally twice daily for six months in an open study. American Fertility Society (AFS) laparoscopic scores pre- and post-treatment, symptom severity, hormonal status, bone density and biochemical indices of bone turnover were studied. Five patients were still menstruating at three months and nafarelin was increased to 400 mcg daily. At the end of treatment, the median serum estradiol was 57 pmol/l and all patients were amenorrhoeic. AFS scores for endometriosis improved significantly in 19/23 (82.6%) patients (p = 0.001). Adhesions were not affected. Symptom severity scores were markedly decreased (p < 0.0001) and remained so six months after the end of treatment. Biochemical indices of bone activation were increased but bone loss was insignificant. During treatment, 23/25 patients reported hot flushes. Nafarelin 200 mcg daily significantly reduced signs and symptoms of endometriosis, although five patients needed a dosage increase before menses stopped. The study suggests that lower doses of nafarelin may be efficacious, although symptomatic changes should be treated with caution due to the open and non-comparative nature of the study.

Topics: Abdominal Pain; Administration, Intranasal; Adult; Bone Density; Dose-Response Relationship, Drug; Dysmenorrhea; Endometriosis; Estradiol; Estrone; Female; Follow-Up Studies; Humans; Infertility, Female; Laparoscopy; Menstruation; Nafarelin; Pregnancy; Severity of Illness Index