Endometriosis Clinical Trial
Official title:
Anti TNFa Treatment for Deep Endometriosis Associated Pain : a Randomised Placebo Controlled Trial.
Deep endometriosis associated pain is believed to be caused by inflammation. Anti TNFa has been proved to be an effective treatment for other inflammation related conditions as Crohn's disease Endometriosis is associated with an inflammatory response in the pelvis, which is mediated by a number of cytokines including TNF-α. It has therefore been suggested that infliximab, an anti-TNF-α monoclonal antibody, might relieve pain in affected women.
In this pilot study, 21 women with severe endometriosis-associated pain and a rectovaginal
nodule, at least 1 cm in diameter on clinical examination, were randomised in a 2 to 1 ratio
to receive intravenous infliximab (n=14) or placebo (n=7) in the three months prior to
laparoscopic laser excision of the nodule.
After a 1 month observation period, all women received three infusions of infliximab
(5mg/kg) or placebo over the course of 6 weeks. Surgery was performed 3 months later and
follow-up continued for a further 6 months. The primary endpoint was the total pain burden
(dysmenorrhoea, deep dyspareunia and non-menstrual pain) rated on a daily basis by the
patient using standard pain scales and analgesic intake as the outcome measures . Secondary
endpoints included the volume of the endometriotic nodule assessed clinically and on
transvaginal ultrasound, the amount of pelvic tenderness on clinical examination and the
presence of other endometriotic lesions at laparoscopy.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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