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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 2

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.3 Patient assessed efficacy, 4 point verbal rating scale at end of treatment (6 months).
Figuras y tablas -
Figure 3

Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.3 Patient assessed efficacy, 4 point verbal rating scale at end of treatment (6 months).

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Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.4 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.4 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).

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Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.5 Change in pain score at 12 months follow‐up (Improvement).
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.5 Change in pain score at 12 months follow‐up (Improvement).

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Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.2 AFS score (improved or remission).
Figuras y tablas -
Figure 6

Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.2 AFS score (improved or remission).

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Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.6 Side effects.
Figuras y tablas -
Figure 7

Forest plot of comparison: 1 Progestagen versus placebo, outcome: 1.6 Side effects.

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Forest plot of comparison: 2 Depot progestagen versus other treatment, outcome: 2.2 Improvement in symptoms.
Figuras y tablas -
Figure 8

Forest plot of comparison: 2 Depot progestagen versus other treatment, outcome: 2.2 Improvement in symptoms.

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Forest plot of comparison: 2 Depot progestagen versus other treatment, outcome: 2.3 Side effects.
Figuras y tablas -
Figure 9

Forest plot of comparison: 2 Depot progestagen versus other treatment, outcome: 2.3 Side effects.

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Forest plot of comparison: 3 Oral progestagens versus other treatment, outcome: 3.1 Patient assessed efficacy (6 months).
Figuras y tablas -
Figure 10

Forest plot of comparison: 3 Oral progestagens versus other treatment, outcome: 3.1 Patient assessed efficacy (6 months).

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Forest plot of comparison: 3 Oral progestagens versus other treatment, outcome: 3.3 Objective efficacy at end of follow‐up (12 months).
Figuras y tablas -
Figure 11

Forest plot of comparison: 3 Oral progestagens versus other treatment, outcome: 3.3 Objective efficacy at end of follow‐up (12 months).

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Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.1 Patient assessed efficacy at end of treatment (6 months).
Figuras y tablas -
Figure 12

Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.1 Patient assessed efficacy at end of treatment (6 months).

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Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.3 Objective assessment of efficacy at end of treatment (6 months).
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Figure 13

Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.3 Objective assessment of efficacy at end of treatment (6 months).

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Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.4 Patient assessed efficacy at end of treatment (6 months).
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Figure 14

Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.4 Patient assessed efficacy at end of treatment (6 months).

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Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.5 Patient assessed efficacy at end of follow‐up (12 months).
Figuras y tablas -
Figure 15

Forest plot of comparison: 4 Anti‐progestagen versus other treatment, outcome: 4.5 Patient assessed efficacy at end of follow‐up (12 months).

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Comparison 1 Progestagen versus placebo , Outcome 1 AFS score .
Figuras y tablas -
Analysis 1.1

Comparison 1 Progestagen versus placebo , Outcome 1 AFS score .

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Comparison 1 Progestagen versus placebo , Outcome 2 AFS score (improved or remission) .
Figuras y tablas -
Analysis 1.2

Comparison 1 Progestagen versus placebo , Outcome 2 AFS score (improved or remission) .

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Comparison 1 Progestagen versus placebo , Outcome 3 Patient assessed efficacy, 4 point verbal rating scale at end of treatment (6 months).
Figuras y tablas -
Analysis 1.3

Comparison 1 Progestagen versus placebo , Outcome 3 Patient assessed efficacy, 4 point verbal rating scale at end of treatment (6 months).

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Comparison 1 Progestagen versus placebo , Outcome 4 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).
Figuras y tablas -
Analysis 1.4

Comparison 1 Progestagen versus placebo , Outcome 4 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).

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Comparison 1 Progestagen versus placebo , Outcome 5 Change in pain score at 12 months follow‐up (Improvement).
Figuras y tablas -
Analysis 1.5

Comparison 1 Progestagen versus placebo , Outcome 5 Change in pain score at 12 months follow‐up (Improvement).

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Comparison 1 Progestagen versus placebo , Outcome 6 Side effects.
Figuras y tablas -
Analysis 1.6

Comparison 1 Progestagen versus placebo , Outcome 6 Side effects.

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Study

Heading 1

Heading 2

Heading 3

Heading 4

Heading 5

painful periods, visual analogue scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 7 (5‐10) and 6.5 (5.1‐8.2) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐3) and 2 (0.5‐3.3) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 0.5 (0‐1.5) respectively

painful periods, verbal rating scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 2 (1‐3) and 2 (1‐3) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 1 (0‐1) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 0 (0‐0) respectively

pain on intercourse, visual analogue scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 4 (0‐8) and 3.5 (0‐8.1) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐2.7) and 0 (0‐3.2) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 0 (0‐0.5) respectively

pain on intercourse, verbal rating scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 1 (0‐2) and 1 (0‐2) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐1) and 0 (0‐1) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 0 (0‐0) respectively

non‐menstrual pain, visual analogue scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 4 (0‐7.5) and 4.1 (1‐7.3) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0.2 (0‐3) and 0 (0‐2) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐1) and 0 (0‐0.5) respectively

non‐menstrual pain, verbal rating scale

Vercellini 1996

Baseline values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 1 (0‐2) and 1 (0‐2) respectively

Month six values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐1) and 0 (0‐0.1) respectively

Month twelve values (range) for depot medroxyprogesterone acetate and oral contraceptive plus danazol were 0 (0‐0) and 0 (0‐0) respectively

Figuras y tablas -
Analysis 2.1

Comparison 2 Depot progestagen versus other treatment, Outcome 1 Patient assessed efficacy during and at end of treatment (6 and 12 months).

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Comparison 2 Depot progestagen versus other treatment, Outcome 2 Improvement in symptoms.
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Analysis 2.2

Comparison 2 Depot progestagen versus other treatment, Outcome 2 Improvement in symptoms.

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Comparison 2 Depot progestagen versus other treatment, Outcome 3 Side effects.
Figuras y tablas -
Analysis 2.3

Comparison 2 Depot progestagen versus other treatment, Outcome 3 Side effects.

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Comparison 3 Oral progestagens versus other treatment, Outcome 1 Patient assessed efficacy (6 months).
Figuras y tablas -
Analysis 3.1

Comparison 3 Oral progestagens versus other treatment, Outcome 1 Patient assessed efficacy (6 months).

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Comparison 3 Oral progestagens versus other treatment, Outcome 2 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).
Figuras y tablas -
Analysis 3.2

Comparison 3 Oral progestagens versus other treatment, Outcome 2 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months).

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Comparison 3 Oral progestagens versus other treatment, Outcome 3 Objective efficacy at end of follow‐up (12 months).
Figuras y tablas -
Analysis 3.3

Comparison 3 Oral progestagens versus other treatment, Outcome 3 Objective efficacy at end of follow‐up (12 months).

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Comparison 3 Oral progestagens versus other treatment, Outcome 4 Improved VAS score.
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Analysis 3.4

Comparison 3 Oral progestagens versus other treatment, Outcome 4 Improved VAS score.

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Comparison 3 Oral progestagens versus other treatment, Outcome 5 Quality of life.
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Analysis 3.5

Comparison 3 Oral progestagens versus other treatment, Outcome 5 Quality of life.

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Comparison 3 Oral progestagens versus other treatment, Outcome 6 Severe/very severe signs and symptoms (24 weeks).
Figuras y tablas -
Analysis 3.6

Comparison 3 Oral progestagens versus other treatment, Outcome 6 Severe/very severe signs and symptoms (24 weeks).

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Comparison 3 Oral progestagens versus other treatment, Outcome 7 Change in pain from baseline to 24 weeks.
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Analysis 3.7

Comparison 3 Oral progestagens versus other treatment, Outcome 7 Change in pain from baseline to 24 weeks.

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Study

6 months

Cyproterone acetate

Visual analogue scale

Cyproterone acetate

Verbal rating scale

Oral contraceptiveVisual analogue scale

Oral contraceptiveVerbal scale

Vercellini 2002

Dysmenorrhoea

Median (IQR)

0 (0 ‐ 0)

n=39

2 (1 ‐ 2)

n=39

74 (59 ‐ 83)

n=36

Vercellini 2002

Deep dyspareunia

Median (IQR)

13 (10 ‐ 30)

n= 23

0 (0 ‐ 1)

n=23

15 (0 ‐ 20)

n = 25

0 (0 ‐ 1 )

n = 25

Vercellini 2002

Non Menstrual pain

Median (IQR)

14 (0 ‐ 40)

n = 22

0 (0 ‐ 1)

n = 22

20 (0 ‐ 30)

n = 20

0 (0 ‐ 1)

n = 20

Figuras y tablas -
Analysis 3.8

Comparison 3 Oral progestagens versus other treatment, Outcome 8 Pain symptom scores.

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Study

Razzi 2007

Both desogestrel and the oral contraceptive showed significant decreases in self reported pain compared to baseline P <0.001. After 6 months the mean VAS score for desogestrel alone was 2.5 and for the oral contraceptive was 2.3. There was no statistical comparison between groups calculated.

Figuras y tablas -
Analysis 3.9

Comparison 3 Oral progestagens versus other treatment, Outcome 9 Self reported pain.

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Study

Razzi 2007

The authors report on breakthrough bleeding in 4/20 patients randomised to desogestrel and increased body weight in 3/20 randomised to oral contraceptive. no other details provided

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Analysis 3.10

Comparison 3 Oral progestagens versus other treatment, Outcome 10 Side effects.

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Comparison 3 Oral progestagens versus other treatment, Outcome 11 Side effects.
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Analysis 3.11

Comparison 3 Oral progestagens versus other treatment, Outcome 11 Side effects.

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 1 Patient assessed efficacy at end of treatment (6 months).
Figuras y tablas -
Analysis 4.1

Comparison 4 Anti‐progestagen versus other treatment, Outcome 1 Patient assessed efficacy at end of treatment (6 months).

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 2 Patient assessed efficacy 6 months after the end of treatment.
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Analysis 4.2

Comparison 4 Anti‐progestagen versus other treatment, Outcome 2 Patient assessed efficacy 6 months after the end of treatment.

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 3 Objective assessment of efficacy at end of treatment (6 months).
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Analysis 4.3

Comparison 4 Anti‐progestagen versus other treatment, Outcome 3 Objective assessment of efficacy at end of treatment (6 months).

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 4 Patient assessed efficacy at end of treatment (6 months).
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Analysis 4.4

Comparison 4 Anti‐progestagen versus other treatment, Outcome 4 Patient assessed efficacy at end of treatment (6 months).

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 5 Patient assessed efficacy at end of follow‐up (12 months).
Figuras y tablas -
Analysis 4.5

Comparison 4 Anti‐progestagen versus other treatment, Outcome 5 Patient assessed efficacy at end of follow‐up (12 months).

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Comparison 4 Anti‐progestagen versus other treatment, Outcome 6 Side effects.
Figuras y tablas -
Analysis 4.6

Comparison 4 Anti‐progestagen versus other treatment, Outcome 6 Side effects.

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Comparison 5 Antiprogestagens (varying dosage), Outcome 1 Subjective improvement in pain.
Figuras y tablas -
Analysis 5.1

Comparison 5 Antiprogestagens (varying dosage), Outcome 1 Subjective improvement in pain.

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Comparison 5 Antiprogestagens (varying dosage), Outcome 2 Objective efficacy ‐ rAFS scores at 6 months.
Figuras y tablas -
Analysis 5.2

Comparison 5 Antiprogestagens (varying dosage), Outcome 2 Objective efficacy ‐ rAFS scores at 6 months.

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Comparison 5 Antiprogestagens (varying dosage), Outcome 3 Side effects.
Figuras y tablas -
Analysis 5.3

Comparison 5 Antiprogestagens (varying dosage), Outcome 3 Side effects.

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Summary of findings for the main comparison. Progestagen compared to placebo for pain associated with endometriosis

Progestagen compared to placebo for pain associated with endometriosis

Patient or population: patients with pain associated with endometriosis
Settings: gynaecology clinics
Intervention: progestagen
Comparison: placebo

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Placebo

Progestagen

AFS score

The mean AFS score in the control groups was
1.76

The mean AFS score in the intervention groups was
0.58 lower
(1.41 lower to 0.25 higher)

33
(1 study)

⊕⊕⊝⊝
low1,2

Patient assessed efficacy, sum of all symptoms
Follow‐up: mean 6 months

The mean patient assessed efficacy, sum of all symptoms in the control groups was
‐5.20

The mean patient assessed efficacy, sum of all symptoms in the intervention groups was
5.2 lower
(6.8 to 3.6 lower)

33
(1 study)

⊕⊕⊝⊝
low1,2

Patient assessed efficacy, sum of all symptoms
Follow‐up: mean 12 months

The mean patient assessed efficacy, sum of all symptoms in the control groups was
‐7.0

The mean patient assessed efficacy, sum of all symptoms in the intervention groups was
7 lower
(8.61 to 5.39 lower)

29
(1 study)

⊕⊕⊝⊝
low1,2

Side effects ‐ acne

59 per 1000

375 per 1000
(59 to 852)

OR 9.6
(1 to 91.96)

33
(1 study)

⊕⊝⊝⊝
very low1,2,3

Side effects ‐ oedema

59 per 1000

688 per 1000
(184 to 956)

OR 35.2
(3.6 to 344.19)

33
(1 study)

⊕⊝⊝⊝
very low1,2,4

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 There was an unclear explanation for randomisation, allocation concealment and blinding
2 Evidence based on a single trial
3 Summary effect crosses line of no effect and substantive harm or benefit
4 Wide confidence intervals indicative of imprecision

Figuras y tablas -
Summary of findings for the main comparison. Progestagen compared to placebo for pain associated with endometriosis
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Summary of findings 2. Depot progestagen compared to other treatment for pain associated with endometriosis

Depot progestagen compared to other treatment for pain associated with endometriosis

Patient or population: patients with pain associated with endometriosis
Settings: gynaecology clinics
Intervention: depot progestagen
Comparison: other treatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Other treatment

Depot progestagen

Improvement in dysmenorrhoea
Follow‐up: mean 6 months

978 per 1000

895 per 1000
(692 to 969)

OR 0.19
(0.05 to 0.69)

274
(1 study)

⊕⊕⊝⊝
low1,2

Improvement in dysmenorrhoea
Follow‐up: mean 12 months

768 per 1000

676 per 1000
(551 to 782)

OR 0.63
(0.37 to 1.08)

274
(1 study)

⊕⊕⊝⊝
low2,3

Side effects ‐ hot flushes

90 per 1000

29 per 1000
(11 to 76)

OR 0.3
(0.11 to 0.83)

354
(2 studies)

⊕⊕⊝⊝
low4,5

Side effects ‐ amenorrhoea

0 per 1000

0 per 1000
(0 to 0)

OR 21.18
(1.18 to 380.9)

80
(1 study)

⊕⊝⊝⊝
very low1,2,6

Side effects ‐ breakthrough bleeding/spotting

28 per 1000

373 per 1000
(157 to 655)

OR 20.56
(6.44 to 65.56)

354
(2 studies)

⊕⊕⊝⊝
low1,4

Side effects ‐ bloating

275 per 1000

625 per 1000
(393 to 811)

OR 4.39
(1.71 to 11.3)

80
(1 study)

⊕⊝⊝⊝
very low1,2,6

Side effects ‐ injection site reaction

0 per 1000

0 per 1000
(0 to 0)

OR 20.64
(1.19 to 358.23)

274
(1 study)

⊕⊕⊝⊝
low1,2

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 Wide confidence intervals indicate some imprecision
2 Evidence based on a single trial
3 Summary effect crosses line of no effect and substantive benefit or harm
4 One of the trials was open label and attrition was not adequately explained
5 I square statistic was 66%
6 Trial was open label and inadequately explained attrition

Figuras y tablas -
Summary of findings 2. Depot progestagen compared to other treatment for pain associated with endometriosis
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Summary of findings 3. Oral progestagens versus other treatment for pain associated with endometriosis

Oral progestagens versus other treatment for pain associated with endometriosis

Patient or population: patients with pain associated with endometriosis
Settings:
Intervention: oral progestagens versus other treatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Oral progestagens versus other treatment

Patient assessed efficacy ‐ pain
Follow‐up: mean 6 months

The mean patient assessed efficacy ‐ pain in the control groups was
21.1

The mean patient assessed efficacy ‐ pain in the intervention groups was
0.1 higher
(0.26 lower to 0.46 higher)

286
(2 studies)

⊕⊕⊕⊝
moderate1

Objective efficacy at end of follow up (12 months) ‐ AFS score

The mean objective efficacy at end of follow up (12 months) ‐ AFS score in the control groups was
1.31

The mean objective efficacy at end of follow up (12 months) ‐ AFS score in the intervention groups was
0.34 higher
(0.01 lower to 0.7 higher)

302
(2 studies)

⊕⊕⊕⊝
moderate2

Side effects ‐ headache

244 per 1000

158 per 1000
(109 to 220)

OR 0.58
(0.38 to 0.87)

613
(3 studies)

⊕⊕⊕⊝
moderate1

Side effects ‐ hot flushes

306 per 1000

178 per 1000
(120 to 251)

OR 0.49
(0.31 to 0.76)

613
(3 studies)

⊕⊕⊝⊝
low1,3

Side effects ‐ genital bleeding

634 per 1000

891 per 1000
(811 to 939)

OR 4.69
(2.47 to 8.9)

271
(1 study)

⊕⊕⊝⊝
low4,5

Side effects ‐ amenorrhoea

387 per 1000

758 per 1000
(645 to 843)

OR 4.95
(2.88 to 8.52)

252
(1 study)

⊕⊝⊝⊝
very low4,5,6

Sleep disorder

78 per 1000

16 per 1000
(3 to 71)

OR 0.19
(0.04 to 0.90)

252
(1 study)

⊕⊝⊝⊝
very low4,5,6

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 One trial did not provide adequate explanation for randomisation, allocation concealment or blinding and the other trial was open label
2 One trial did not explain adequately details for allocation concealment, randomisation and blinding
3 I2 statistic was 65%
4 Wide confidence intervals, indicative of imprecision
5 Evidence based on a single
6 Open label trial

Figuras y tablas -
Summary of findings 3. Oral progestagens versus other treatment for pain associated with endometriosis
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Summary of findings 4. Anti‐progestagen compared to other treatment for pain associated with endometriosis

Anti‐progestagen compared to other treatment for pain associated with endometriosis

Patient or population: patients with pain associated with endometriosis
Settings: gynaecology clinics
Intervention: anti‐progestagen
Comparison: other treatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

other treatment

Anti‐progestagen

Patient assessed efficacy none or mild painful periods (dysmenorrhoea)
Follow‐up: mean 6 months

667 per 1000

673 per 1000
(524 to 794)

OR 1.03
(0.55 to 1.93)

176
(2 studies)

⊕⊕⊝⊝
low1

Objective assessment of efficacy at end of treatment (6 months) ‐ rAFS scores

The mean objective assessment of efficacy at end of treatment (6 months) ‐ rAFS scores in the control groups was
11.8

The mean objective assessment of efficacy at end of treatment (6 months) ‐ rAFS scores in the intervention groups was
1.4 higher
(6.76 lower to 9.56 higher)

16
(1 study)

⊕⊝⊝⊝
very low2,3,4

Patient assessed efficacy painful periods
visual analogue scale
Follow‐up: mean 12 months

The mean patient assessed efficacy painful periods in the control groups was
4.76

The mean patient assessed efficacy painful periods in the intervention groups was
3 lower
(4.79 to 1.21 lower)

55
(1 study)

⊕⊕⊕⊝
moderate4

Side effects ‐ seborrhoea

204 per 1000

413 per 1000
(303 to 534)

OR 2.74
(1.69 to 4.46)

357
(3 studies)

⊕⊕⊝⊝
low1

Side effects ‐ hirsutism

248 per 1000

465 per 1000
(346 to 588)

OR 2.63
(1.6 to 4.32)

302
(2 studies)

⊕⊝⊝⊝
very low1,5

Side effects ‐ hot flushes

464 per 1000

360 per 1000
(267 to 462)

OR 0.65
(0.42 to 0.99)

357
(3 studies)

⊕⊝⊝⊝
very low1,6

Side effects ‐ amenorrhoea

962 per 1000

500 per 1000
(200 to 905)

OR 0.04
(0.01 to 0.38)

49
(1 study)

⊕⊕⊝⊝
low3,4

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

1 Inadequate explanation of randomisation and allocation concealment, one of the trials was open label
2 Open label trial with inadequate allocation concealment
3 Wide confidence intervals indicative of imprecision
4 Evidence based on a single trial
5 I2 statistic was 68%
6 I2 statistic was 78%

Figuras y tablas -
Summary of findings 4. Anti‐progestagen compared to other treatment for pain associated with endometriosis
Ir a la tabla de la revisión
Comparison 1. Progestagen versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AFS score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 AFS score (improved or remission) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 Patient assessed efficacy, 4 point verbal rating scale at end of treatment (6 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 pelvic pain

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 sum of all symptoms

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 pelvic pain

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 sum of all symptoms

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Change in pain score at 12 months follow‐up (Improvement) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6 Side effects Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6.1 acne

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 oedema

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 muscle cramps

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.4 spotting

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 1. Progestagen versus placebo
Ir a la tabla de la revisión
Comparison 2. Depot progestagen versus other treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Patient assessed efficacy during and at end of treatment (6 and 12 months) Show forest plot

Other data

No numeric data

1.1 painful periods, visual analogue scale

Other data

No numeric data

1.2 painful periods, verbal rating scale

Other data

No numeric data

1.3 pain on intercourse, visual analogue scale

Other data

No numeric data

1.4 pain on intercourse, verbal rating scale

Other data

No numeric data

1.5 non‐menstrual pain, visual analogue scale

Other data

No numeric data

1.6 non‐menstrual pain, verbal rating scale

Other data

No numeric data

2 Improvement in symptoms Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2.1 dysmenorrhoea 6 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 dysmenorrhoea 12 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 dyspareunia 6 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.4 dyspareunia 12 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.5 pelvic pain 6 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.6 pelvic pain 12 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.7 pelvic tenderness 6 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.8 pelvic tenderness 12 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.9 induration 6 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.10 induration 12 months

1

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Side effects Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 acne/greasy skin (seborrhoea)

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

4.75 [0.94, 23.98]

3.2 hot flushes

2

354

Odds Ratio (M‐H, Fixed, 95% CI)

0.30 [0.11, 0.83]

3.3 breast pain/tension

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.24 [0.34, 4.43]

3.4 headaches

2

354

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.48, 1.73]

3.5 dizziness

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

3.08 [0.12, 77.80]

3.6 nausea

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

3.86 [1.12, 13.26]

3.7 weight gain

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

2.58 [1.03, 6.46]

3.8 amenorrhoea

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

21.18 [1.18, 380.90]

3.9 breakthrough bleeding/spotting

2

354

Odds Ratio (M‐H, Fixed, 95% CI)

20.56 [6.44, 65.56]

3.10 bloating

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

4.39 [1.71, 11.30]

3.11 depression

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.18 [0.38, 3.63]

3.12 asthenia

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 16.56]

3.13 peripheral oedema

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

2.05 [0.18, 23.59]

3.14 injection site reaction

1

274

Odds Ratio (M‐H, Fixed, 95% CI)

20.64 [1.19, 358.23]

3.15 insomnia

1

274

Odds Ratio (M‐H, Fixed, 95% CI)

0.42 [0.11, 1.67]

3.16 decreased libido

1

274

Odds Ratio (M‐H, Fixed, 95% CI)

0.42 [0.11, 1.67]
Figuras y tablas -
Comparison 2. Depot progestagen versus other treatment
Ir a la tabla de la revisión
Comparison 3. Oral progestagens versus other treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Patient assessed efficacy (6 months) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 pain

2

286

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.26, 0.46]

1.2 sum of all symptoms

1

34

Mean Difference (IV, Fixed, 95% CI)

0.50 [‐1.10, 2.10]

2 Patient assessed efficacy, 4 point verbal rating scale at end of follow‐up (12 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 pelvic pain

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 sum of all symptoms

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Objective efficacy at end of follow‐up (12 months) Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 AFS score

2

302

Mean Difference (IV, Fixed, 95% CI)

0.34 [‐0.01, 0.70]

4 Improved VAS score Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5 Quality of life Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 physical health summary scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 mental health summary scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 bodily pain

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Severe/very severe signs and symptoms (24 weeks) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7 Change in pain from baseline to 24 weeks Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

7.1 abdominal pain

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 lumbago

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Pain symptom scores Show forest plot

Other data

No numeric data

9 Self reported pain Show forest plot

Other data

No numeric data

10 Side effects Show forest plot

Other data

No numeric data

11 Side effects Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 acne

2

286

Odds Ratio (M‐H, Fixed, 95% CI)

0.60 [0.24, 1.49]

11.2 oedema

1

34

Odds Ratio (M‐H, Fixed, 95% CI)

2.75 [0.67, 11.24]

11.3 muscle cramps

1

34

Odds Ratio (M‐H, Fixed, 95% CI)

0.46 [0.09, 2.27]

11.4 spotting

2

124

Odds Ratio (M‐H, Fixed, 95% CI)

0.73 [0.35, 1.54]

11.5 headache

3

613

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.38, 0.87]

11.6 weight gain

2

342

Odds Ratio (M‐H, Fixed, 95% CI)

1.09 [0.51, 2.33]

11.7 depression

2

342

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.37, 1.97]

11.8 decreased libido

2

342

Odds Ratio (M‐H, Fixed, 95% CI)

1.24 [0.52, 2.94]

11.9 hair loss

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.16, 2.02]

11.10 migraine

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.50 [0.12, 2.06]

11.11 sleep disorder

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.04, 0.90]

11.12 vaginal dryness

2

342

Odds Ratio (M‐H, Fixed, 95% CI)

0.47 [0.15, 1.48]

11.13 hot flushes

3

613

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.31, 0.76]

11.14 study withdrawal due to side effects

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

1.25 [0.37, 4.21]

11.15 genital bleeding

1

271

Odds Ratio (M‐H, Fixed, 95% CI)

4.69 [2.47, 8.90]

11.16 amenorrhoea

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

4.95 [2.88, 8.52]

11.17 bloating or swelling

1

90

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.37, 2.19]

11.18 irritability

1

90

Odds Ratio (M‐H, Fixed, 95% CI)

3.14 [0.31, 31.42]

11.19 nausea

1

90

Odds Ratio (M‐H, Fixed, 95% CI)

0.10 [0.01, 1.94]
Figuras y tablas -
Comparison 3. Oral progestagens versus other treatment
Ir a la tabla de la revisión
Comparison 4. Anti‐progestagen versus other treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Patient assessed efficacy at end of treatment (6 months) Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 none or mild pelvic pain

2

230

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.33, 1.56]

1.2 none or mild painful periods (dysmenorrhoea)

2

214

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.39, 1.33]

1.3 none or mild pain on intercourse (dyspareunia)

2

222

Odds Ratio (M‐H, Fixed, 95% CI)

0.83 [0.37, 1.86]

2 Patient assessed efficacy 6 months after the end of treatment Show forest plot

2

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

2.1 none or mild pelvic pain

2

202

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.20 [0.58, 2.48]

2.2 none or mild painful periods (dysmenorrhoea)

2

176

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.03 [0.55, 1.93]

2.3 none or mild pain on intercourse (dyspareunia)

2

192

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.94 [0.42, 2.09]

3 Objective assessment of efficacy at end of treatment (6 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 rAFS scores

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 implant score

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Patient assessed efficacy at end of treatment (6 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 painful periods, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 painful periods, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 pain on intercourse, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.4 pain on intercourse, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.5 non‐menstrual pain, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.6 non‐menstrual pain, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Patient assessed efficacy at end of follow‐up (12 months) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 painful periods, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 painful periods, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 pain on intercourse, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.4 pain on intercourse, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.5 non‐menstrual pain, visual analogue scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.6 non‐menstrual pain, verbal rating scale

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Side effects Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 acne

2

302

Odds Ratio (M‐H, Fixed, 95% CI)

1.45 [0.90, 2.33]

6.2 seborrhoea

3

357

Odds Ratio (M‐H, Fixed, 95% CI)

2.74 [1.69, 4.46]

6.3 hirsutism

2

302

Odds Ratio (M‐H, Fixed, 95% CI)

2.63 [1.60, 4.32]

6.4 voice problems

2

302

Odds Ratio (M‐H, Fixed, 95% CI)

0.70 [0.34, 1.43]

6.5 swelling hands/feet

2

319

Odds Ratio (M‐H, Fixed, 95% CI)

1.48 [0.88, 2.48]

6.6 hot flushes

3

357

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.42, 0.99]

6.7 sweating problems

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.88, 2.35]

6.8 loss of libido

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

1.32 [0.80, 2.19]

6.9 decreased breast size

2

302

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.38, 0.98]

6.10 leg or muscle cramps

3

357

Odds Ratio (M‐H, Fixed, 95% CI)

0.48 [0.30, 0.77]

6.11 headaches

2

319

Odds Ratio (M‐H, Fixed, 95% CI)

0.99 [0.64, 1.53]

6.12 nausea

3

357

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.84, 2.16]

6.13 vomiting

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.32, 1.43]

6.14 loss of appetite

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.72, 2.37]

6.15 hunger

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

0.59 [0.36, 0.97]

6.16 dizziness

2

319

Odds Ratio (M‐H, Fixed, 95% CI)

1.27 [0.77, 2.08]

6.17 tiredness

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

1.44 [0.84, 2.45]

6.18 faintness

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

1.23 [0.54, 2.76]

6.19 skin rash

2

319

Odds Ratio (M‐H, Fixed, 95% CI)

1.76 [0.95, 3.24]

6.20 weight gain

1

38

Odds Ratio (M‐H, Fixed, 95% CI)

0.34 [0.09, 1.27]

6.21 vaginal dryness

2

93

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.02, 1.66]

6.22 raised liver transaminases

1

38

Odds Ratio (M‐H, Fixed, 95% CI)

0.18 [0.01, 4.00]

6.23 stopped treatment because of side effects

1

264

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.47, 1.57]

6.24 asthenia

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.8 [0.19, 3.36]

6.25 mood changes

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.10, 4.34]

6.26 dermatitis

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

8.14 [0.40, 165.53]

6.27 joint pain

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

2.16 [0.18, 25.32]

6.28 drowsiness

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

2.16 [0.18, 25.32]

6.29 tachycardia

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.06, 17.49]

6.30 insomnia

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

3.23 [0.13, 82.71]

6.31 hypertrichosis

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

3.23 [0.13, 82.71]

6.32 constipation

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

3.23 [0.13, 82.71]

6.33 itching

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.55]

6.34 vaginal discharge

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.55]

6.35 parasthesia

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 8.55]

6.36 suffered any side effect

1

55

Odds Ratio (M‐H, Fixed, 95% CI)

0.59 [0.20, 1.77]

6.37 amenorrhoea

1

49

Odds Ratio (M‐H, Fixed, 95% CI)

0.04 [0.01, 0.38]

6.38 spotting or bleeding

1

49

Odds Ratio (M‐H, Fixed, 95% CI)

22.92 [2.64, 198.66]
Figuras y tablas -
Comparison 4. Anti‐progestagen versus other treatment
Ir a la tabla de la revisión
Comparison 5. Antiprogestagens (varying dosage)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Subjective improvement in pain Show forest plot

1

Peto Odds Ratio (Peto, Fixed, 95% CI)

Subtotals only

2 Objective efficacy ‐ rAFS scores at 6 months Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3 Side effects Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 noted any side effect

1

12

Odds Ratio (M‐H, Fixed, 95% CI)

23.40 [0.89, 612.98]

3.2 discontinued treatment because of headaches

1

12

Odds Ratio (M‐H, Fixed, 95% CI)

3.55 [0.12, 105.82]

3.3 discontinued treatment because of continuing pain

1

12

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.01, 8.42]

3.4 suffered from irregular bleeding

1

12

Odds Ratio (M‐H, Fixed, 95% CI)

0.4 [0.03, 6.18]
Figuras y tablas -
Comparison 5. Antiprogestagens (varying dosage)
Ir a la tabla de la revisión