Comparative study of aromatase inhibitor, letrozole, versus medroxy-progesterone acetate for the treatment of endometrial hyperlasia

Abstract EN

Objectives.

To compare the efficacy of 5.0 mg oral letrozole tablet$ versus m^roxy-progestrone acetate 10 mg tablet$ for three and six months, for the treatment of endometrial hyperplasia without atypia.

Design: A double blind randomized comparative trial Setting: Suez Canal University Hospital Participants.

Forty patients, 35 to 45 years of age.

All participants were complaining of irregular uterine bleeding.

All were proved to have no pelvic pathology by clinical and trans-vaginal ultrasound examination.

Dilatation of the cervix and endometrial biopsy for all cases showed simple or glandular endometrial hyperplasia without atypia.

Methods: The women were randomized after counseling into two groups.

Groups ل (n=20) had given medroxy-progesterone acetate 5 mg twice daily.

Group II (n=20) had given 2.5 mg letrozole tablets twice daily.

The duration needed for the stopping of bleeding, the need for further intervention or treatment was recorded.

Moreover, after 3 and 6 months both groups had another endometrial biopsy re-evatoated.

the investigator was blind to the allocation as the drugs were dispersed by the hospital pharmacy in registered code.

Results: Medroxy-progesterone was found to be significantly more effective in controlling the uterine bleeding compared to letrozole (mean duration 8.3 in-group ا versus 12.1 days in-group II, p<0.01).

However, letrozole was statistically insignificant in returning the normal endometrial pattern after 3 month treatment compared to medroxy-progestone (p>0.3) on the other hand, letrozole was statistically significant in returning the normal endometrial pattern after 6 month treatment compared to medroxy-progesterone (p<0.01).

Finally, the need for further intervention was less in the letrozole Group.

Conclusion: Letrozole is slower in controlling bleeding in cases of endometrial hyperplasia compared to medroxy-progesterone acetate.

However, it is more effective in returning the normal endometrial pattern after 6 month treatment, this may justify the cost of letrozole therapy.