Table 1.
Patient characteristics and results of randomized controlled trials analyzing the efficacy of progestin treatment in women with EH
| Author | Year | Study type | Number of patients | Population characteristics | Intervention | Regression of EH | Persistence/pro-gression of EH | Side effects |
|---|---|---|---|---|---|---|---|---|
| Dolapcioglu [97] | 2013 | RCT | 104 | simple EH (n = 61), atypical EH (n = 43) | Oral MPA (10 mg/day; n = 52) vs. LNG-IUD (n = 52) both for 3–6 months; 2-year follow-up | 64% (MPA) vs. 100% (LNG-IUD) after 6 months | 22/51 (43%) for MPA vs. 4/51 (8%) for LNG-IUD after 2 years; 50% (MPA) vs. 84% (LNG-IUD) after 3 months | – |
| Orbo [98] | 2008 | RCT | 258 | EH without further differentiation | LNG-IUD vs. oral progestin, observation for 6 months; follow-up for 24 months | LNG-IUD more effective vs. oral progestins and observation after 6 months (p = 0.001) and after follow-up | No case of EC during follow-up (56 to 108 months) | – |
| Ismail [99] | 2013 | RCT | 90 | EH without atypia | Cyclical MPA 10 mg/day vs. cyclical NETA 15 mg/day vs. LNG-IUD for 6 months | 36.6% vs. 40% vs. 66.7% | No case of EC | – |
| Karimi-Zarchi [100] | 2013 | RCT | 40 | EH without atypia | Cyclical MPA 20 mg/day vs. LNG-IUD for 3 months | LNG-IUD more effective (p < 0.05) | – | Better satisfaction; less side effects with LNG-IUD |
| El-Behery [101] | 2015 | RCT | 138 | EH without further differentiation; diagnosed by ultrasound | Oral dydrogesterone vs. LNG-IUD for 6 months | LNG-IUD more effective (96% vs. 80%) | Recurrence rate lower with LNG-IUD (0% vs. 12%) | Patient satisfaction better with LNG-IUD despite more spotting |
| Orbo [102]; Update of [98] | 2016 | RCT | 153 | EH without further differentiation | LNG-IUD vs. oral progestin vs. observation for 6 months; follow-up for 24 months | – | Histological recurrence in 55/135 (41%) with CR; Recurrence rates similar in three therapy groups; recurrence dependent on menopausal status (p = 0.0005) and estrogen level (p = 0.0007) | – |
| Pooled analysis | – | RCT (n = 6 including one Update) | 783 | – | – | LNG-IUD with higher rates vs. oral progestins in all studies | LNG-IUD with lower rates of persistence/recurrence in 2 studies | Less side effects with LNG-IUD in 1 study; better patient satisfaction in 2 studies |