Oral progestogens vs LNG-IUS for endometrial hyperplasia

January 01, 0001

Oral progestogens vs LNG-IUS for endometrial hyperplasia

These UK authors conducted a systematic review and meta- analysis of observational studies evaluating the regression rate of endometrial hyperplasia with oral progestogens and levonorgestrel-releasing intrauterine system. The methodologic index for nonrandomized studies was used for quality assessment. Meta-analysis was performed with random effects model.

They found: "There were 24 observational studies (1001 women), of low methodologic quality, evaluating the outcome of regression of endometrial hyperplasia with oral progestogens or levonorgestrel-releasing intrauterine system. Meta-analysis showed that oral progestogens achieved a lower pooled regression rate compared with levonorgestrel-releasing intrauterine system for complex (pooled rate, 66% vs 92%) and atypical hyperplasia (pooled rate, 69% vs 90). There was no statistical difference in simple hyperplasia (pooled rate, 89% vs 96%)."

The authors concluded: "Oral progestogens appear to induce a lower disease regression rate than Levonorgestrel-releasing intrauterine system in the treatment of endometrial hyperplasia."

These conclusions are limited by the quality of the studies included. Randomized controlled trials are still needed.

For the full abstract, click here.

Am J Obstet Gynecol 203(6):547.e1-547.e10, December 2010
© 2010 to Mosby, Inc.
Oral progestogens vs levonorgestrel-releasing intrauterine system for endometrial hyperplasia: a systematic review and metaanalysis. Ioannis D.Gallos, Manjeet Shehmar, Shakila Thangaratinam, Thalis K. Papapostolou, Arri Coomarasamy, Janesh K. Gupta.

Category: X. Female Genital System, Breast. Keywords: endometrial hyperplasia, levonorgestrel intrauterine system, LNG- IUS, progestogens, meta-analysis of observational studies, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 18 January 2010

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