The Comparison Of Mifepristone And GnRH-a For Endometriosis Post-Operation Management:a Meta-Analysis

Objective:To compare the effects and safety of mifepristone and GnRH-a for endometriosis after conservative surgery treatment.Methods:Based on the principle of evidence-based medicine, use Cochrane systematic review method to retrieve randomized controlled trials published on CNKI, Wanfang database, VIP database, Pubmed, Embase and Cochrane. All the culations and statistie altests were done with the RevMan5.3 software.Results:A total of 10 trials (718 patients) were included. All of the 10 trails were took over endometriosis conservative surgery. In different dose and course of treatment, the result of Meta-analysis showed:1、There were no statistical significant differences about complete remission rate[OR=0.70,95%CI(0.30-1.65)], partial remission rate[OR=1.42, 95%CI(0.61-3.34)], total effective rate[OR=0.78,95%CI(0.19-3.14)] and recurrence rate[OR=0.83,95%CI(0.33-2.13)] of 6 months for 12.5mg of mifepristone.2、There were no statistical significant differences about complete remission rate[OR=1.32,95%CI(0.47-3.72)], partial remission rate[OR=1.28, 95%CI(0.37-4.37)], total effective rate[OR=2.05,95%CI(0.18-23.44)] and recurrence rate[OR=1.30,95%CI(0.34-4.98)] of 3 months for 12.5mg of mifepristone.3、The group 6 months 10mg of mifepristone, it’s total effective rate was lower than GnRH-a[OR=0.25,95%CI(0.09-0.71)], while there were no statistical significant differences about complete remission rate[OR=0.54, 95%CI(0.28-1.01)], partial remission rate[OR=1.03,95%CI(0.53-1.99)] and recurrence rate[OR=1.40,95%CI(0.22-9.01)].4、There were no statistical significant differences of effect of liver function under both intervention groups that used for 6 months. The group 3 months of mifepristone has less effects on liver function [OR=0.16,95%CI(0.04-0.64)].5、The main side effect of mifepriston is mild gastrointestinal symptoms, while GnRH-a often cause hypostrogenic symptoms and bone loss.Conclusion:Limited evidence shows that compared with GnRH-a, there were no significant differences of effectiveness by using 12.5mg mifepriston after endometriosis conservative surgery, hypostrogenic symptoms and bone loss were fewer, few of patients had appeared mild gastrointestinal symptoms or a slight elevation of transaminase. The impact on endometrium of mifespristone is uncertain now, for clear and convicing evidence, more trial is nessesary.