Finkelstein 1998.

Study characteristics
Methods	Trial design: Randomised controlled trial
Participants	Participants: 43 women were randomised and 39 analysed. Mean age: Group 1: 31 ± 7 years, group 2: 32 ± 7 years Inclusion criteria: Symptomatic, laparoscopically proven endometriosis  Participated in the original study Ovulation was confirmed in the menstrual cycle before entry into the study by a luteal‐phase serum progesterone level more than 16 nmol/L (5 ng/dL). Normal serum calcium, inorganic phosphate, alkaline phosphatase, bilirubin, creatinine, free T4 index, and PRL concentrations Exclusion criteria:  Women with disorders or taking medications known to affect bone metabolism Oral contraceptive and danazol use was discontinued for at least 2 months and GnRH analog therapy was discontinued for at least 9 months before entry into the study. Setting: United States of America Timing: not stated
Interventions	GnRH analog nafarelin acetate (Synarel, Syntex Laboratories, Inc, Palo Alto, Calif), 200 μg intranasally twice daily, for 12 months (group 1, n = 22)  versus Nafarelin acetate plus human PTH‐(1‐34), 40 μg (500 U) subcutaneously daily, for 12 months (group 2, n = 21)
Outcomes	Bone mineral density Adverse effects Improvement of most troublesome symptom Laboratory/biochemical values
Notes	Intention‐to‐treat analysis: yes Sample size calculation: not stated Funding: This work was supported by National Institutes of Health grants R29 DK43341 and RR1066 and a National of Institutes of Health Clinical Associate Physician Award (Dr Finkelstein).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation was conducted by a research biostatistician not otherwise involved in the study.
Allocation concealment (selection bias)	Low risk	The women were randomly assigned. Randomisation was performed using computer‐generated cards that were numbered sequentially and kept in opaque, sealed envelopes until entry into the study.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Because we and our local institutional review board felt that the use of placebo hPTH‐(1‐34) injections was unethical, no placebo was used. Thus, neither the patients nor the investigators were blinded with respect to treatment.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	The person reading the bone density scans, however, was blinded with respect to treatment assignment, as were the technicians who performed the biochemical analyses.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Four women in group 2 (4/21) withdrew from the study after 3 months (n = 2) or 6 months (n = 2). Reasons for withdrawal included hot flashes and mild weight gain (n = 1), excessive distance from study site (n = 1), discomfort from injections (n = 1), and depression (n = 1). All data from these women are included and analysed with their originally assigned group.
Selective reporting (reporting bias)	Low risk	The study protocol was not available but it was clear that the published reports included all expected outcomes, including those that were prespecified.
Other bias	Low risk	No other risk of bias detected