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A progestin isn’t a progestin: dienogest for endometriosis as a blueprint for future research – Review as a contribution for discussion -

  • Michael Oettel , Hans Joachim Zentel and Klaus Nickisch EMAIL logo
Published/Copyright: July 15, 2020
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Hormone Molecular Biology and Clinical Investigation
From the journal Hormone Molecular Biology and Clinical Investigation Volume 42 Issue 2

Abstract

The different etiopathogenetic mechanisms and the diversity of clinical features of endometriosis has not yet allowed to identify a causal pharmacological monotherapy satisfying the unresolved medical needs in this important female disease. Therefore, despite the search for new therapeutic principles for the indication, the strategy of gradual optimization of established therapeutic principles should not be disregarded.

In the case of progestins, the fact that each compound has its own, specific profile may allow to study the therapeutic relevance of the various signal cascades influenced by their receptors.

Using the example of the progestin dienogest, the different genomic and non-genomic mechanisms of action are discussed. It is pharmacodynamic profile is unique compared to other progestins.

In light of the emerging multitude of pathomechanisms in endometriosis, a monotherapy may not be possible, and then the search for broad spectrum compounds or combination therapies with dual or multiple mode of action in a clinically relevant dose range might be considered. The progestogenic action may greatly benefit from, by way of example, additional anti-inflammatory and/or anti-fibrotic and/or pro-apoptotic activities. Such a strategy could lead to new drug classes.

Keywords: dienogest; endometriosis; progestins; screening strategy
Corresponding author: Klaus Nickisch, Evestra GmbH, Britzer Straße 26, Berlin, 12439, Germany. Phone: +49 30 66509642, E-mail:

Part of this article is presented on behalf of the European Progestogen Club at the 13th Congress of the European Society of Gynecology, October 16–19, 2019, Vienna/Austria.

Funding source: Evestra

  1. Research funding: Sponsored by Evestra.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: There are no conflicts of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2020-02-10
Accepted: 2020-05-02
Published Online: 2020-07-15

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/hmbci-2020-0013
Keywords for this article
dienogest; endometriosis; progestins; screening strategy

Articles in the same Issue

  1. Frontmatter
  2. Special Section: "Progestogen-only pill and its therapeutic indications and effects"; Guest Editors: Adolf E- Schindler and René Druckmann
  3. Original Articles
  4. Peritoneal fluid biomarkers in patients with endometriosis: a cross-sectional study
  5. Safety, influence on the endometrium, sonographic changes and bleeding profile after 13 cycles with the new drospirenone only pill (DOP) for contraception
  6. Review Articles
  7. A progestin isn’t a progestin: dienogest for endometriosis as a blueprint for future research – Review as a contribution for discussion -
  8. Progestogens in luteal support
  9. Mini Review
  10. Progestogen-only pills: which progestogen would be ideal
  11. Regular Issue
  12. Original Articles
  13. Outcomes of surgical and/or medical treatment in patients with prolactinomas during long-term follow-up: a retrospective single-centre study
  14. PPARGC1A promoter DNA-methylation level and glucose metabolism in Ecuadorian women with Turner syndrome
  15. Allium jesdianum hydro alcoholic extract ameliorates diabetic nephropathy by suppressing connective tissue growth factor (CTGF) and receptor for advanced glycation endproducts (RAGE) gene expression in diabetic rats with streptozotocin
  16. Changes in serum levels of Apo AIV in patients with newly diagnosed hyperthyroidism and hypothyroidism: a preliminary study
  17. The study of ischemia modified albumin as an early biomarker of epilepsy in adolescent population: a cross-sectional study
  18. Short Communications
  19. The effect of water-based rhythmic exercise training on glucose homeostasis and thyroid hormones in postmenopausal women with metabolic syndrome
  20. Evaluation of glutathione reductase activity in colon tissue of patients with irritable bowel syndrome
  21. Case Report
  22. A rare association of two endocrine tumours: non-functional oncocytic adrenocortical carcinoma and Papillary thyroid carcinoma
  23. Mini Review
  24. Vitamin D and new insights into pathophysiology of type 2 diabetes
  25. Review Articles
  26. Sex steroids-induced neurogenesis in adult brain: a better look at mechanisms and mediators
  27. Genetic variants and risk of thyroid cancer among Iranian patients
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