Safety and Effectiveness of Dienogest (Visanne®) for Treatment of Endometriosis: A Large Prospective Cohort Study

• Published in: Reproductive sciences (Thousand Oaks, Calif.) Vol. 27; no. 3; pp. 905 - 915
• Main Authors: Cho, BaikSeol, Roh, Ju-Won, Park, Jonghoon, Jeong, Kyungah, Kim, Tae-Hee, Kim, Yun Sook, Kwon, Yong-Soon, Cho, Chi-Heum, Park, Sung Ho, Kim, Sung Hoon
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.03.2020
• Subjects: Adult; Embryology; Endometriosis - complications; Endometriosis - drug therapy; Female; Hormone Antagonists - therapeutic use; Humans; Medicine; Medicine & Public Health; Middle Aged; Nandrolone - analogs & derivatives; Nandrolone - therapeutic use; Obstetrics/Perinatology/Midwifery; Original Article; Pain - complications; Pain - prevention & control; Prospective Studies; Reproductive Medicine; Treatment Outcome; Endometriosis; Effectiveness; Safety; Cohort study; Dienogest
• ISSN: 1933-7191; 1933-7205; 1933-7205
• DOI: 10.1007/s43032-019-00094-5

Dienogest (DNG) is a progestin with highly selective progesterone activity and known to be effective in the treatment of endometriosis. This prospective cohort study in patients who had been treated with DNG 2 mg (Visanne ® ) for endometriosis was conducted to assess the safety and effectiveness of DNG in a large Korean cohort. This study included 3356 patients with endometriosis from 73 centers in Korea. All patients were treated with DNG 2 mg daily and were followed up for at least 6 months after initial visit. Any adverse events were recorded including severity, onset/closing date, outcomes, treatments, and the causality with DNG. Effectiveness of DNG was measured by changes in visual analogue scale (VAS) from baseline at the end of follow-up. The mean age of the subjects was 34.96 years, and the mean duration of treatment was 285.44 days. Incidence of adverse drug reaction (ADR) was 13.27% (413/3113). The most frequently reported ADR were “abnormal uterine bleeding” 4.14% (129/3113), “increased weight” 2.57% (80/3113), and “headache” 1.22% (38/3113). The number of patients (%) with favorable bleeding patterns was observed to increase as the duration of treatment increases. Amenorrhea was observed in 29.63%, 41.25%, 46.26%, and 53.20% of patients at 3 months, 6 months, 12 months, and more than 12 months follow-up period, respectively. The mean (±SD) VAS change from baseline at the last follow-up visit was −28.19 ± 28.39 mm ( P value < 0.0001). This large cohort study confirms, in routine clinical practice, that DNG is safe and effective for treatment of endometriosis.