Use of intraperitoneal interferon α-2b therapy after conservative surgery for endometriosis and postoperative medical treatment with depot gonadotropin-releasing hormone analog: a randomized clinical trial

Acién, Pedro; Quereda, Francisco; Campos, Adolfo; Gomez-Torres, Marı́a-José; Velasco, Irene; Gutierrez, M.A.

doi:10.1016/s0015-0282(02)03330-7

Cited by 49 publications

(25 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, this finding was observed with IL-2 and interferon-␣ in rats with experimental endometriosis [34] . We also observed improvement in experimental endometriosis with the administration of interferon-␣ 2b in rats [17] , but leaving this drug intraperitoneally during conservative surgery has not produced beneficial effects in human endometriosis [18] . In general, therefore, findings are discrepant between rats and human beings.…”

Section: Discussionmentioning

confidence: 71%

“…In other papers examining previous clinical trials using rIL-2 intracyst [14,15] , we exposed the antecedent and fundamentals of the use of immunomodulators for the treatment of endometriosis [4,5,[17][18][19][20][21][22][23][24] . Basically, immunomodulators such as IL-2 can enhance the cytotoxic activity of macrophages and NK cells at the pelvic level as well as in endometriomas, thereby contributing to the elimination of endometriosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage and Recombinant Interleukin-2 Left in the Cysts: A Third Clinical Trial

Acién

Velasco

Acién

et al. 2009

Gynecol Obstet Invest

Self Cite

View full text Add to dashboard Cite

Background: To analyze the therapeutic results of recombinant interleukin-2 (rIL-2) left in the cysts after transvaginal ultrasound (US)-guided drainage of endometriomas as an alternative to surgery. Methods: Prospective and randomized clinical trial. A total of 25 consecutive patients were included. Two transvaginal US-guided punctures were performed, and 3 million IU of rIL-2 were left in the aspirated cysts once (group I) or both (group II) times according to randomization. Main Outcome Measures: Clinical results, prevented surgeries, and recurrences. Results: Results were moderate or good in only 16% of subjects at 3 months and in 33% of subjects at 6 months after treatment in group I; these numbers were 66 and 33%, respectively, in group II. Differences were not statistically significant. However, the evolution of symptoms, endometriomas, and CA-125 revealed the low efficacy of rIL-2 left intracyst as well as a poor control of the clinical manifestations. After 1 year, 20% (group I) and 73% (group II) of patients had to be operated; after 2 years, these numbers were 55 and 82%, respectively. Conclusions: Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts, without using endometrial suppressive therapy with GnRH analogues as done in previous studies, has low efficacy. Recurrences are even more frequent after the use of two rIL-2 doses.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage and Recombinant Interleukin-2 Left in the Cysts: A Third Clinical Trial

Acién

Velasco

Acién

et al. 2009

Gynecol Obstet Invest

Self Cite

View full text Add to dashboard Cite

show abstract

“…For example, it has been claimed that, in affected women, refluxed endometrial cells are able to escape T-cell-driven immune surveillance [2] and that T-cell activating drugs should ameliorate the disease. However, in two small randomized clinical trials, the immune-stimulatory cytokines IL-2 and IFN-a had no effect on lesion size or pain [3,4]. These results indicate that these two cytokines cannot repair defects in immune surveillance or that impaired T-cell function is not critical to EMS pathogenesis.…”

mentioning

confidence: 92%

Mast cells in endometriosis: guilty or innocent bystanders?

Kirchhoff

Kaulfuß

Fuhrmann

et al. 2012

Expert Opinion on Therapeutic Targets

View full text Add to dashboard Cite

“…But our group [14] has shown that although two short regimens of human interferon-␣ 2b reduced the size of experimental endometriosis in rats, this interferon-␣ 2b left intraperitoneally in women after conservative surgery for endometriosis increased later recurrences of the disease [15] . Likewise, IL-2 could be recommended for the same purpose of control of ectopic endometrial growth since it triggers NK cell activation by T cells, activates the growth and expansion of T lymphocytes and causes the cytolysis of aberrant ectopic cells, correcting in vitro the immunological defects of endometriosis [4] .…”

Section: Discussionmentioning

confidence: 97%

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage under GnRH Analogues and Recombinant Interleukin-2 Left in the Cysts

Acién¹,

Pérez-Albert²,

Quereda³

et al. 2005

Gynecol Obstet Invest

Self Cite

View full text Add to dashboard Cite

Background: To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues. Methods: Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four consecutive patients with endometriomas initially sent to us for laparotomy and conservative surgery for endometriosis were included. Interventions: Treatment with GnRH analogues every 28 days, 3 doses. Under their effect, one or two transvaginal US-guided punctures were performed in order to aspirate the endometriomas, and 3 million IU of rIL-2 were left in the aspirated cysts each time. Main outcome measures: Clinical results: two menstruations after GnRH analogues. Other secondary outcome measures were: the time until recurrence of cysts, symptoms and CA-125 >35 U/ml, and the need for further medical or surgical treatment. Results: They were moderate or good in >50% of cases with one drainage and one dose of 3 million IU of rIL-2 intracyst, but were better with a second drainage and two doses of rIL-2 (25 vs. 58.3% ‘good results’). There were fewer recurrences and the interval before recurrence was longer after two doses but differences were not significant. Six patients from group I (50%) and 3 from group II (25%) needed laparotomy and conservative surgery at 17.5 ± 8.7 months (total time of follow-up = 33 ± 8.8 months). Conclusions: Treatment of endometriomas with transvaginal US-guided drainage and rIL-2 left in the cysts under endometrial suppressive therapy with GnRH analogues has beneficial effects, improving clinical manifestationsand avoiding some surgical therapies. The use of a higher dose of rIL-2 does not produce better results, whereas drainage + rIL-2 twice does.

show abstract

Use of intraperitoneal interferon α-2b therapy after conservative surgery for endometriosis and postoperative medical treatment with depot gonadotropin-releasing hormone analog: a randomized clinical trial

Cited by 49 publications

References 27 publications

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage and Recombinant Interleukin-2 Left in the Cysts: A Third Clinical Trial

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage and Recombinant Interleukin-2 Left in the Cysts: A Third Clinical Trial

Mast cells in endometriosis: guilty or innocent bystanders?

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage under GnRH Analogues and Recombinant Interleukin-2 Left in the Cysts

Contact Info

Product

Resources

About