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Novel treatment modalities
Published in Seema Chopra, Endometriosis, 2020
Tanaproget is a newly developed SPRM. In vitro studies show this drug to be efficacious in down-regulation of endometrial matrix metalloproteinase expression. It showed regression of experimental endometriosis in in vivo studies in mice with disease established by tissues from patients with endometriosis with use of tanaproget [44]. Still, there is no recommendation for the use of tanaproget in humans.
Current status and challenges of drug development for hormonal treatment of endometriosis: a systematic review of randomized control trials
Published in Gynecological Endocrinology, 2022
Vendy Zajec, Mislav Mikuš, Salvatore Giovanni Vitale, Maurizio Nicola D’alterio, Marija Gregov, Marko Jakov Šarić, Jose Carugno, Stefano Angioni, Mario Ćorić
SPRMs are a class of synthetic ligands that have a variable effect (agonist, antagonist, or mixed effect) on progesterone receptors in various target tissues. They have emerged as a potential treatment option for hormone-dependent diseases such as uterine fibroids, endometriosis, breast cancer, and uterine cancer [33]. Because of their lesser effect on estradiol and androgen levels, treatment with SPRMs is not associated with systemic hypoestrogenic side effects. In addition, they suppress endometrial prostaglandin and decrease menstruation, thereby reducing EAPP [34]. The most clinically studied SPRM, mifepristone, is approved for the induction of medical abortions. In addition, mifepristone, ulipristal acetate, and asoprisnil are FDA-approved as emergency contraceptives, and ulipristal is also approved in Europe and Canada for the treatment of uterine fibroids. The most recently developed SPRM, tanaproget, and the aforementioned SPRMs have been studied in several trials for the treatment of endometriosis [35]. However, most of the studies are not RCTs and have not been published in the last decade and are therefore not included in this review.