Meta analysis of levonorgestrel releasing intrauterine system and mifepristone in the treatment of adenomyosis / 中国医师杂志

ABSTRACT

Objective:To evaluate the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) (mirena) versus mifepristone therapy for adenomyosis.Methods:We retrived the Cochrane library, the Pubmed, EMbase, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, China Biomedical Literatue Database (CBM) and other databases to identify randomized controlled trials (RCTs) involving the comparison of levonorgestrel-releasing intrauterine system and mifepristone up to October 2018. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Then data were analyzed with Stata 11.0 software.Results:A total of 17 RCTs involving 1 772 patients were included. The results indicated that mirena was more effective than mifepristone [RR=1.25, 95% CI(1.19, 1.32), P<0.01]. The decrease in endometrial thickness [MD=-1.94, 95% CI(-2.19, -1.70), P<0.01], uterine volume [MD=-18.99, 95% CI(-19.90, -18.07), P<0.01] and the incidence of adverse reactions [RR=0.67, 95% CI(0.47, 0.95), P=0.026] in mirena group were significantly different compared with the mifepristone group. Also the dysmenorrhea score and menstrual blood volume of mirena group were lower than mifepristone group ( P<0.05). Conclusions:Current evidence shows that the efficacy and safety of mirena was better than mifepristone in the treatment for adenomyosis patients. Since the limitation of quantity and quality of included studies, large-scale high-quality RCTs are needed to verify the above conclusion.