Return of Chronic Pelvic Pain From Endometriosis After Raloxifene Treatment

Pamela Stratton, Ninet Sinaii, James H. Segars, James Segars, Deloris E. Koziol, Deloris Koziol, Robert Wesley, C. Zimmer, Carolyn Zimmer, Craig Winkel, Craig A. Winkel, Lynnette K Nieman
Obstetrics and gynecology · 2008 · vol. 111(1) , pp. 88–96 · doi:10.1097/01.aog.0000297307.35024.b5 · PMID:18165396 · W2003063828
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Raloxifene treatment significantly shortened the time to chronic pelvic pain recurrence in women with endometriosis compared to placebo, though endometriosis lesions did not correlate with pain return.

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Abstract

OBJECTIVE: To evaluate whether 6 months of raloxifene was effective in treatment of chronic pelvic pain in women with endometriosis. METHODS: Women with chronic pelvic pain and no endometriosis treatment for 6 months underwent laparoscopy for excision of all lesions. Those with biopsy-proven endometriosis were randomly allocated to raloxifene (180 mg) or placebo daily. A second laparoscopy was performed at 2 years, or earlier, if pain returned. Return of pain was defined as 2 months of pain equal to or more severe than that at study entry. Menstrual cycles and adverse events were recorded. The log rank test was used to compare the time to return of pain by drug group. Analyses were done as intent-to-treat. RESULTS: A total of 127 of 158 women underwent surgery. Of these, 93 had biopsy-confirmed endometriosis and were randomly assigned to study treatment. Menstrual cycle length, pelvic pain severity, quality of life, bone mineral density, and adverse events did not differ between treatment groups. The Data Safety Monitoring Committee terminated the study early when the raloxifene group experienced pain (P=.03) and had second surgery (P=.016) significantly sooner than the placebo group. Interestingly, biopsy-proven endometriosis was not associated with return of pain (P=.6). CONCLUSION: Raloxifene significantly shortened the time to return of chronic pelvic pain. Because recurrence of endometriosis lesions did not correlate with return of pain, other factors are implicated in pelvic pain. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.cliicaltrials.gov, NCT00001848 LEVEL OF EVIDENCE: I.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Pelvic Pain Raloxifene Hydrochloride Selective Estrogen Receptor Modulators Adult Chronic Disease Endometriosis Endometriosis Female Humans Laparoscopy Pelvic Pain Quality of Life Raloxifene Hydrochloride Recurrence Selective Estrogen Receptor Modulators Treatment Outcome

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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