Both long-acting progestogens and combined oral contraceptive pills were found to reduce endometriosis pain by 40%, but progestogens required fewer additional surgeries, according to recent trial results.
The PRE-EMPT trial, published in BMJ, evaluated the efficacy of long-acting progestogens (LAPs) compared with combined oral contraceptive pills (COCPs) in preventing the recurrence of endometriosis-related pain post-surgery. This open-label, randomized controlled trial involved 405 women aged 16-45 years from 34 UK hospitals. Participants were randomized to receive either LAPs (n=205) or COCPs (n=200).
After three years, there was no significant difference in pain scores between the groups (adjusted mean difference, -0.8; 95% CI, -5.7 to 4.2; p=0.76). Both groups showed approximately a 40% improvement from preoperative pain levels, with mean reductions of 24 points in the LAP group and 23 points in the COCP group. Women in the LAP group required fewer additional surgical interventions or second-line treatments compared with those in the COCP group (73 vs. 97 events; hazard ratio, 0.67; 95% CI, 0.44 to 1.00).
The study concluded that both LAPs and COCPs effectively manage endometriosis-related pain post-surgery. The reduced need for further surgical intervention with LAPs may make it a preferable option for some women, according to the researchers.
The study was funded by the National Institute for Health and Care Research (NIHR), and some authors disclosed receiving fees from pharmaceutical companies.