ArticleInternational journal of women's health2026
Achieving Minimal-to-No Pain in Women with Endometriosis Treated with Relugolix Combination Therapy: SPIRIT Extension Trial.
Article in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Relugolix is an oral, non-peptide gonadotropin-releasing hormone receptor antagonist administered as once-daily combination therapy (relugolix-CT; 40 mg relugolix, 1 mg estradiol, 0.5 mg norethindrone acetate) to reduce endometriosis symptoms while potentially minimizing hypoestrogenic effects. In the 24-week SPIRIT1&2 studies, relugolix-CT significantly improved endometriosis-associated pain versus placebo, with improvements sustained over the 80-week open-label Long-Term Extension (LTE; all received relugolix-CT). This post hoc analysis of SPIRIT1, 2 and LTE data assessed temporal effects of relugolix-CT on minimal-to-no pain, amenorrhea, and analgesic-free status. Patients and Methods: This analysis included women who received relugolix-CT, delayed relugolix-CT, or placebo in SPIRIT 1 or 2 and entered the LTE. Cumulative probability and median time to minimal-to-no pain for dysmenorrhea and non-menstrual pelvic pain (NMPP), amenorrhea, and analgesic-free status were assessed. Results: In SPIRIT1&2, 802/1261 women entered the LTE; 501/802 completed 104-week treatment. Median time to minimal-to-no pain for dysmenorrhea was 8 weeks for relugolix-CT and delayed relugolix-CT and was not reached with placebo within 24 weeks; cumulative probability of minimal-to-no dysmenorrhea at Week 24 was 82.5%, 86.4%, and 22.4%, respectively, increasing to 95.3%, 95.9%, and 94.9% at Week 104. Amenorrhea paralleled dysmenorrhea. Median time to minimal-to-no NMPP was 32, 28, and 40 weeks in the relugolix-CT, delayed relugolix-CT, and placebo groups, respectively; cumulative probability of minimal-to-no NMPP was 42.6%, 42.2%, and 28.9% at Week 24, increasing to 70.5%, 74.7%, and 74.3% at Week 104. In the relugolix-CT group, median time to analgesic-free status was 16 weeks; 68.8% and 94.9% were analgesic-free at Weeks 24 and 104. Delayed relugolix-CT results were similar. Analgesic-free status improved in the placebo group after relugolix-CT initiation. Conclusion: In this post hoc analysis, women receiving relugolix-CT for up to 104 weeks had rapid dysmenorrhea improvement with amenorrhea and reduced analgesic use, with longer treatment associated with further NMPP reduction.
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