Trial reportBMJ (Clinical research ed.)2024
Long acting progestogens versus combined oral contraceptive pill for preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic, parallel group, open label, randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical and endocrine effects of pharmacological therapy in endometriosis: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Comparison of the short-term effects of dienogest and oral contraceptives on pain and quality of life in women with endometriosis: a systematic review and meta-analysis.BMC women's health · 2025Pooled it
- Progestagens for pain symptoms associated with endometriosis.The Cochrane database of systematic reviews · 2025Pooled it
- MCT-modified ketogenic diet as an adjunct to standard treatment regimen could alleviate clinical symptoms in women with endometriosis.BMC women's health · 2025Trial
- Trial
- A cohort study on inflammatory response and coagulation function changes in women with silver clip or silk ligation sterilisation.Annals of medicine · 2026Article
- Endothelial cell heterogeneity drives angiogenesis in endometriosis: mechanisms and emerging organoid-based models.Apoptosis : an international journal on programmed cell death · 2026Review
- Epidemiology, Risk Factors, Diagnosis, and Comorbidities of Endometriosis: An Umbrella Review.Journal of clinical medicine · 2026Review
- Laparoscopic hysterectomy versus open abdominal hysterectomy for women with a benign gynaecological condition: the LAVA RCT.Health technology assessment (Winchester, England) · 2026Article
- Analyzing the Risk Factors for Recurrence of Endometrioma and Dysmenorrhea in Patients with Endometriosis.International journal of women's health · 2026Article
- Misdiagnosis rate of endometriosis and strategies employed to identify endometriosis by analyzing patient characteristics in low-resource settings.SAGE open medicine · 2026Article
- Precision Therapeutic and Preventive Molecular Strategies for Endometriosis-Associated Infertility.International journal of molecular sciences · 2025Review
- Evaluating quality of life improvements in endometriosis patients following laparoscopic surgery using EHP-30 scale.Scientific reports · 2025Observational
- Non-Surgical Options for The Diagnosis of Endometriosis in Low-Resource Settings: A Comparative Study.International journal of women's health · 2025Article
- Hormonal and complimentary treatments for endometriosis: a narrative review.Gynecology and pelvic medicine · 2025Review
- Review
- The long road of drug development for endometriosis - Pains, gains, and hopes.Journal of controlled release : official journal of the Controlled Release Society · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the clinical effectiveness of long acting progestogens compared with the combined oral contraceptive pill in preventing recurrence of endometriosis related pain.
designThe PRE-EMPT (preventing recurrence of endometriosis) pragmatic, parallel group, open label, randomised controlled trial.
setting34 UK hospitals.
participants405 women of reproductive age undergoing conservative surgery for endometriosis.
interventionsParticipants were randomised in a 1:1 ratio using a secure internet facility to a long acting progestogen (depot medroxyprogesterone acetate or levonorgestrel releasing intrauterine system) or the combined oral contraceptive pill.
main outcome measuresThe primary outcome was pain measured three years after randomisation using the pain domain of the Endometriosis Health Profile 30 (EHP-30) questionnaire. Secondary outcomes (evaluated at six months, one, two, and three years) included the four core and six modular domains of the EHP-30, and treatment failure (further therapeutic surgery or second line medical treatment).
results405 women were randomised to receive a long acting progestogen (n=205) or combined oral contraceptive pill (n=200). At three years, there was no difference in pain scores between the groups (adjusted mean difference -0.8, 95% confidence interval -5.7 to 4.2, P=0.76), which had improved by around 40% in both groups compared with preoperative values (an average of 24 and 23 points for long acting progestogen and combined oral contraceptive pill groups, respectively). Most of the other domains of the EHP-30 also showed improvement at all time points compared with preoperative scores, without evidence of any differences between groups. Women randomised to a long acting progestogen underwent fewer surgical procedures or second line treatments compared with those randomised to the combined oral contraceptive pill group (73
conclusionsPostoperative prescription of a long acting progestogen or the combined oral contraceptive pill results in similar levels of improvement in endometriosis related pain at three years, with both groups showing around a 40% improvement compared with preoperative levels. While women can be reassured that both options are effective, the reduced risk of repeat surgery for endometriosis and hysterectomy might make long acting reversible progestogens preferable for some.
trial registrationISRCTN registry ISRCTN97865475.
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Registered trials
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.