Tratamento farmacológico para endometriose

In: Research, Society and Development · 2021 · vol. 10(7) , pp. e52810716104 · doi:10.33448/rsd-v10i7.16104 · W3176702887
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This review of 15 articles published between 2008-2018 found that current endometriosis treatments primarily manage symptoms, with dienogest being the only specific treatment, and that new promising therapies are under investigation.

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Abstract

A endometriose é uma doença ginecológica que se caracteriza pela presença de endométrio como tecido-epitélio e estroma que se desenvolve fora da cavidade uterina. É uma doença crónica, estrogênio-dependente, é associada com dor pélvica, dismenorreia, dispareunia e infertilidade. Dado o grande impacto desta doença na qualidade de vida das mulheres, tem-se verificado um interesse crescente na descoberta de novos fármacos mais eficazes, tolerabilidade e segurança. Para isso, realizou-se uma revisão da literatura a partir de artigos publicados entre os anos de 2008 a 2018 disponíveis a respeito dos Tratamentos farmacológicos para endometriose, nas bases de dados SCIENCE DIRECT e PUBMED. Encontrou-se um total de 223 artigos publicados nos últimos 10 anos, em “português e inglês”. Após avaliação dos artigos, foram selecionados 15 artigos para o presente estudo, que cumpriram com todos os critérios de elegibilidade proposto na metodologia. Concluiu-se que podemos contar com vários tipos de tratamentos para endometriose, mas que a maioria tem como objetivo tratar os sintomas associados à endometriose. Atualmente o tratamento específico que podemos contar é o Dienogeste. Além disso, existem muitos estudos em busca de novas drogas e tratamentos promissores para essa patologia. Assim, fazem-se necessárias mais pesquisas a respeito do tema e que o farmacêutico tem papel fundamental para a adesão ao tratamento do paciente.
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Pharmacological treatment for endometriosis DOI: https://doi.org/10.33448/rsd-v10i7.16104Keywords: Pharmacological Treatment, Endometriosis, Combined therapy.Abstract Endometriosis is a gynecological disease characterized by the presence of endometrium as tissue-epithelium and stroma that develops outside the uterine cavity. It is a chronic, estrogen-dependent disease, is associated with pelvic pain, dysmenorrhea, dyspareunia and infertility. Given the great impact of this disease on the quality of life of women, there has been a growing interest in the discovery of new drugs that are more effective, tolerability and safety. For this, a literature review was carried out from articles published between 2008 and 2018 available regarding pharmacological treatments for endometriosis in the SCIENCE DIRECT and PUBMED databases. A total of 223 articles published in the last 10 years were found in "Portuguese and English". After evaluating the articles, 15 articles were selected for the present study, which complied with all the eligibility criteria proposed in the methodology. It was concluded that we can count on several types of treatments for endometriosis, but most have the objective of treating the symptoms associated with endometriosis. Currently, the specific treatment we can count on is dienogeste. In addition, there are many studies in search of new drugs and promising treatments for this pathology. Thus, more research is needed regarding the theme and that the pharmacist plays a fundamental role in the adherence to the patient's treatment. References Abushahin, F. (2011). Aromatase inhibition for refractory endometriosis-related chronic pelvic pain. Fertil. Steril, v. 96, p. 939–942. Amaral, P. P. (2017). Aspectos diagnósticos e terapêuticos da endometriose. FAEMA. Ariquemes-RO. Anderes, K. L., et al. (2008). Biological characterization of a novel, orally active small molecule gonadotropin-releasing hormone (GnRH) antagonist using castrated and intact rats. J. Pharmacol, v. 305, p. 688–695. Brasil. Ministério da Saúde. (2002). Política Nacional de Promoção da Saúde (Documento para discussão). Secretaria de Políticas Públicas, Brasília, DF. Chabbert-Buffet, N., et al. (2008). Selective progesterone receptor modulators and progesterone antagonists: mechanisms of action and clinical applications, Hum. Reprod. v. 11, p. 293–307. Clemenza, S., et al., (2018). From pathogenesis to clinical practice: Emerging medical treatments for endometriosis, Best Practice & Research Clinical. Obstetrics and Gynaecology. Durón, G. R., Bolaños, M. P. (2018). Endometriosis. Costa Rica, Março. Febrasgo – (2017). Federação Brasileira das Associações de Ginecologia e Obstetrícia - São Paulo. Figueiredo, J., Nascimento, R. Avaliação da qualidade de vida de pacientes portadoras de endometriose após inserção do Sistema Intra-Uterino Liberador de Levonorgestrel (SIU-LNg). ACM, v. 37, p. 4, 2008. Khazali, S. (2016). Endometriosis Classification-The Quest for the Holy Grail? J Reprod Infertil; v.17. Kodaman, P. H. (2015). Current Strategies for Endometriosis Management. Obstetrics and Gynecology Clinics of North America, v. 42, p. 87-101. Kumar, P., Sharma, A. (2014). Gonadotropin-releasing hormone analogs: understanding advantages and limitations, J. Hum. Reprod, v. 7, p. 170–174. Mabrouk, M., et al. (2018). Short-term histopathological effects of dienogest therapy on ovarian endometriomas: in vivo, nonrandomized, controlled trial. Gynecol Endocrinol, v. 34(5); 399-403. Novella-Maestre, E., et al., (2009). Dopamine agonist administration causes a reduction in endometrial implants through modulation of angiogenesis in experimentally induced endometriosis. Hum. Reprod, v. 24, p. 1025–1035. Pereira, A. S., et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM. Santos, D. B., et al. (2012). Uma abordagem integrada da endometriose. UFRB, Bahia. Silva, D. M. (2017). Ensaio clínico randomizado duplo cego com resveratrol no tratamento da dor por endometriose. Universidade Federal do Rio Grande do Sul. Porto Alegre. Tavares, N. M. C. (2018). Satisfação e padrões de sangramento das usuárias do sistema intrauterino liberador de levonorgestrel como contraceptivo e comparação com o implante contraceptivo liberador de etonogestrel em mulheres com dor pélvica associada à endometriose. 2018. 1 recurso online (98 p.). Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP. Disponível em: Taylor, H. S., et al. (2017). Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist. The New England journal of medicine, v. 377, p.28-40. Yuan, P., et. al., (2010). Induction of a local pseudo-pregnancy for the treatment of endometriosis. Medical Hypotheses, v. 74; 56-58, China. Zhao, Y., et al., (2015). Dual suppression of estrogenic and inflammatory activities for targeting of endometriosis, Transl. Med, V. 7; 271. Downloads Published Issue Section License Copyright (c) 2021 Camila Maria do Nascimento Santos; Luiz Eduardo Macêdo do Monte ; José Chagas Pinheiro Neto; Higo José Neri da Silva; Antonia Filha Moreira de Melo; Sérgio Henrique Assunção Lacerda Borges; Alisson Camilo Martins Sousa; Juciara Carvalho de Oliveira; Fabiana de Souza Santana; Anna Letícia de Sousa Marinho; Márcia Araújo Gualberto ; Ian Jhemes Oliveira Sousa ; Rodrigo Lopes Gomes Gonçalves; Kelly Maria Rêgo da Silva; Iluska Martins Pinheiro This work is licensed under a Creative Commons Attribution 4.0 International License. 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