Reduction of Postoperative Adhesions after Laparoscopic Surgery for Endometriosis by Using a Novel Anti-Fibrotic Drug Pirfenidone: A Randomized Double Blind Study

Impacts of endometrioma on ovarian aging from basic science to clinical management

“…For instance, both in-vitro and in-vivo studies demonstrated that Sirolimus, which was approved for myeloma, induced regression of endometriotic lesions through inhibiting angiogenesis and proliferation ( 152 – 154 ). Anti-fibrotic agent Pirfenifone was proven to reduce postoperative adhesions for women with endometriosis ( 155 ). Siltuximab, an antiviral agent targeting IL-6, is one of the drug candidates for endometriosis-related infertility from the computational drug discovery ( 156 ).…”

Endometriosis, the Silent Disease: Molecular Targets, Active Principles, and Drug Delivery Systems

“…Completed, results not available Pirfenidone (4) [35] Randomized double-blind clinical trial with 210 patients -Placebo Prevention of postoperative endometriosis induced adhesions (laparoscopy before and after intervention)…”

“…A therapeutic option to modulate TGF‐β is pirfenidone ( 4 ), a pyridine drug approved for the treatment of pulmonary fibrosis [55] that acts by inhibiting fibroblast activation and reducing collagen synthesis [74,75] . A double‐blind randomized controlled clinical trial of 210 endometriosis patients given oral pirfenidone showed that pirfenidone was effective at reducing endometriosis lesions, however, the side effects were too severe for it to be recommended [35] …”

“…[74,75] A double-blind randomized controlled clinical trial of 210 endometriosis patients given oral pirfenidone showed that pirfenidone was effective at reducing endometriosis lesions, however, the side effects were too severe for it to be recommended. [35] Fibrosis has only recently begun to be proposed as a therapeutic target for endometriosis, and preclinical work on primary cell cultures has shone light on mechanisms leading to fibrosis. For translation to an effective therapy, it would be important to know how effectively fibrosis can be targeted at different stages of the disease, and whether it is possible to reverse or merely prevent fibrosis in endometriosis.…”

“…Table 2 compares the respective advantages of oral and vaginal drug delivery for endometriosis therapy. After orally administered pirfenidone (4) was shown to be efficacious yet undesirable due to its adverse event profile, [35] our research group developed vaginal ovules to deliver pirfenidone locally. [111] Vaginal drug administration may lend itself well to endometriosis therapy.…”