Endometriosis Clinical Trial
Official title:
Endometriosis: Immunomodulation
The purpose of this study is to compare the effect of rosiglitazone versus placebo on soluble proinflammatory markers in peritoneal fluid of women with endometriosis.
The overall goal of this proposal is to assess modulation of immune mechanisms in
endometriosis. Endometriosis is a common ailment affecting approximately five million
reproductive-aged American women. We will test the efficacy of a novel immunomodulatory drug
(peroxisome proliferator activated receptor gamma, PPAR-gamma, agonist), rosiglitazone, to
reduce peritoneal fluid cytokine concentrations in women with endometriosis compared with
placebo controls (randomized controlled trial). Based on prior studies done by the
investigator highlighting the major role of cytokines and the immune system in the genesis
or propagation of endometriosis, these experiments could lead to improved translational
treatment strategies and a better understanding of endometriosis. Acting through PPAR-gamma,
TZDs inhibit proinflammatory cytokines as well as NF-kB, an important nuclear transcription
factor for the production of many cytokines. Accordingly, since human endometrial epithelial
and stromal cells contain PPAR-gamma, we felt it would be useful to evaluate the influence
of a PPAR-gamma ligand, rosiglitazone, on the concentration of specific peritoneal fluid
cytokines.
Comparison: After the pre-trial screening, eligible subjects with presumed endometriosis and
age 18-45 will be consented and randomly assigned to receive either placebo (control) or
rosiglitazone, Avandia®, 4 mg daily for 2 weeks. Peritoneal fluid will be collected at the
time of surgery and the volume measured. All patients enrolled in the study will have their
surgery during the follicular phase of the cycle in order to minimize differences in volume
and cytokine concentration due to the cyclical changes. The primary measure will be the
peritoneal fluid concentration comparisons of the two groups assessing six different
cytokines: interleukin-1 beta, RANTES, tumor necrosis factor-alpha and vascular endothelial
growth factor.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Diagnostic
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