Evidence map›Paper›PMID 37217824›Full record

SynthesisReproductive sciences (Thousand Oaks, Calif.)2023

The Efficacy of Dienogest in Reducing Disease and Pain Recurrence After Endometriosis Surgery: a Systematic Review and Meta-Analysis.

Ludovico Muzii, Chiara Di Tucci, Giulia Galati, Fabiana Carbone, Innocenza Palaia, Giorgio Bogani, Giorgia Perniola, Federica Tomao, Evangelos Kontopantelis, Violante Di Donato

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Reproductive sciences (Thousand Oaks, Calif.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
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  12. Observational
  13. Article
  14. Review
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  17. Clinical Guidance Paper VVOG: Pharmacological treatment of endometriosis-related pain.European journal of obstetrics & gynecology and reproductive biology: X · 2025
    Article
  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Ludovico MuziiDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy. ludovico.muzii@uniroma1.it.ORCID 0000-0001-7195-9583
Chiara Di TucciDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Giulia GalatiDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Fabiana CarboneDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Innocenza PalaiaDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Giorgio BoganiDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Giorgia PerniolaDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Federica TomaoDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Evangelos KontopantelisDivision of Informatics, Imaging and Data Sciences, University of Manchester, Greater Manchester, Manchester, UK.
Violante Di DonatoDepartment of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico, 155-00161, Rome, Italy.
Policlinico Umberto I · ITUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The objective of this study is to determine whether dienogest therapy after endometriosis surgery reduces the risk of recurrence compared with placebo or alternative treatments (GnRH agonist, other progestins, and estro-progestins). The design used in this study is systematic review with meta-analysis. The data source includes PubMed and EMBASE searched up to March 2022. A systematic review and meta-analysis were performed in accordance with guidelines from the Cochrane Collaboration. Keywords such as "dienogest," "endometriosis surgery," "endometriosis treatment," and "endometriosis medical therapy" were used to identify relevant studies. The primary outcome was recurrence of endometriosis after surgery. The secondary outcome was pain recurrence. An additional analysis focused on comparing side effects between groups. Nine studies were eligible, including a total of 1668 patients. At primary analysis, dienogest significantly reduced the rate of cyst recurrence compared with placebo (p < 0.0001). In 191 patients, the rate of cyst recurrence comparing dienogest vs GnRHa was evaluated, but no statistically significant difference was reported. In the secondary analysis, a trend toward reduction of pain at 6 months was reported in patients treated with dienogest over placebo, with each study reporting a significantly higher reduction of pain after dienogest treatment. In terms of side effects, dienogest treatment compared with GnRHa significantly increased the rate of spotting (p = 0.0007) and weight gain (p = 0.03), but it was associated with a lower rate of hot flashes (p = 0.0006) and a trend to lower incidence of vaginal dryness. Dienogest is superior to placebo and similar to GnRHa in decreasing rate of recurrence after endometriosis surgery. A significantly higher reduction of pain after dienogest compared with placebo was reported in two separate studies, whereas a trend toward reduction of pain at 6 months was evident at meta-analysis. Dienogest treatment compared with GnRHa was associated with a lower rate of hot flashes and a trend to lower incidence of vaginal dryness.

Indexed as

CystsEndometriosisNandroloneFemaleHot FlashesHumansPelvic PainProgestinsdienogestNandroloneProgestinsDienogestEndometriomaEndometriosisPostoperative medical treatmentRecurrence

Identifiers

PMID37217824
PMCPMC10643411
OpenAlexW4377287545

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.