Background: Endometriosis commonly presents with dysmenorrhea, non-menstrual pelvic pain, and infertility. Elagolix is an oral, short-acting, gonadotropin-releasing hormone antagonist acting through complete estrogen suppression.
Objective: To evaluate the evidence from published randomized controlled trials (RCTs) about the efficacy and safety of Elagolix in the treatment of endometriosis associated pain.
Search strategy: Electronic databases containing articles published between January 2000 and February 2020 were searched using the MeSH terms (Elagolix OR gonadotropin-releasing hormone antagonist OR GnRH antagonist OR antigonadotropin) AND (endometriosis) AND (pelvic pain).
Selection criteria: All RCTs assessing the efficacy of Elagolix in the treatment of pain associated with endometriosis were considered for this network meta-analysis, where five studies were deemed eligible for this review.
Data collection and analysis: The mean difference (MD) and confidence intervals (95% CI) for continuous outcomes including analgesic use, dysmenorrhea, non-menstrual pelvic pain, and quality of life were calculated.
Main results: Elagolix 250 mg reduced dysmenorrhea significantly, as compared to placebo, (MD = -0.41, 95% CI [-0.7, -0.13]) at 12 weeks, while Elagolix 200 mg reduced dysmenorrhea significantly (MD= -1.2, 95% CI [-1.9, -0.57]) compared to placebo after 24 weeks of treatment.
Conclusions: Elagolix 200 mg seems to be an effective drug with fewer side effects when used to reduce dysmenorrhea and non-menstrual pelvic pain after 24 weeks of treatment in patients with endometriosis.
Endometriosis, Elagolix, GnRH antagonist, pain, dysmenorrhea
The authors report no conflict of interest.
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This work is licensed under a Creative Commons Attribution 4.0 License.
Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics
Mattar OM, Namous LO, Ros M, Fathi M, Elgendy FA, Elghazaly SM, Ibrahim AH, Gadallah A, Faraag EAM, Sayed O, Samy A, Abbas AM. Efficacy and safety of Elagolix in the treatment of endometriosis associated pain: a systematic review and network meta-analysis. POG in Press. 2021 April; Article 2 [ 13 p.].
Additional FilesElagolix supplemental Figure no.1. Geometry of network meta-analysis.pdf (13 kB)
Elagolix Supplemental figure no. 2. Forest plot showing the efficacy outcomes of different interventions.pdf (263 kB)
Elagolix Supplemental figure no. 3. The ranking probability of the interventions for the efficacy outcomes.pdf (272 kB)
Elagolix supplemental figure no. 4. Forest plot showing the side effects of different interventions.pdf (253 kB)
Elagolix supplemental figure no. 5. The ranking probability of the interventions for side effects.pdf (275 kB)