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Cited by 58Endometriosis Research and TreatmentUterine Myomas and TreatmentsMenstrual Health and Disorders

Gonadotropin-releasing hormone antagonist (linzagolix): A new therapy for uterine adenomyosis

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Donnez, Olivier, Donnez, Jacques·2020·Fertility and Sterility
DOI 10.1016/j.fertnstert.2020.04.017
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Abstract

Objective To compare the efficacy of a selective progesterone receptor modulator, ulipristal acetate, and a gonadotropin-releasing hormone antagonist, linzagolix, in a case of severe uterine adenomyosis.Design Case report.Setting Private clinic and infertility research unit.Patient One patient born in 1981 who presented because of heavy menstrual bleeding, pelvic pain, and dysmenorrhea due to diffuse and disseminated uterine adenomyosis confirmed by magnetic resonance imaging (MRI).Intervention The patient received a first treatment of 5 mg UPA daily for one course of 3 months. This therapy was discontinued because MRI revealed a worsened aspect. One year later, a once-daily dose of 200 mg linzagolix administered orally was initiated for 3 months, followed by another 3-month course of 100 mg once daily.Main outcome measures Clinical symptoms and MRI aspect.Results During treatment with UPA, the symptoms (pelvic pain, dysmenorrhea, bulk symptoms) worsened and MRI revealed aggravation of the adenomyotic lesions. During the 12-week course of once-daily 200 mg linzagolix, the patient remained in amenorrhea and noted a very significant improvement in symptoms. On MRI, the uterine volume had fallen from 875 cm 3 to 290 cm 3, and the adenomyotic lesions had significantly regressed. During the 100-mg linzagolix course (weeks 13-24), the patient reported continued alleviation of her symptoms.Conclusion To our knowledge, this is the first reported use of linzagolix, a new oral gonadotropin-releasing hormone antagonist that significantly reduced lesion size and improved quality of life in a patient with severe adenomyosis, who was previously nonresponsive to treatment with a selective progesterone receptor modulator, ulipristal acetate.

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  • A recent paper demonstrated the efficacy of linzagolix 200 mg in reducing lesion size and improving quality of life in case of severe adenomyosis, which is often associated with deep endometriosis.

    “A recent paper demonstrated the efficacy of linzagolix 200 mg in reducing lesion size and improving quality of life in case of severe adenomyosis, which is often associated with deep endometriosis [108,115].”

    From Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review (2021) · cites this paper as [108]

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Authors
Donnez, O., & Donnez, J.
Affiliations
UCLouvain (BE)
Corresponding author
Donnez, Jacques
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2020-09
Volume
114
Issue
3
Pages
640-645
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2020.04.017
OpenAlex
W3033691887
Cited by
58
References
43
Citations by year
2026: 5 · 2025: 2 · 2024: 5 · 2023: 17 · 2022: 9 · 2021: 14 · 2020: 6
FWCI
10.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Keywords
uterine adenomyosis, linzagolix, GnRH antagonist, ulipristal acetate, selective progesterone receptor modulators, menorrhagia, dysmenorrhea, pelvic pain, treatment non-response, quality of life
MeSH terms
Adult, Female, Hormone Antagonists, Humans, Gonadotropin-Releasing Hormone, Magnetic Resonance Imaging, Norpregnadienes, Remission Induction, Severity of Illness Index, Uterus, Treatment Failure, Disease Progression, Drug Substitution, Adenomyosis

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