Remember, this is educational information only and not medical advice – always check with your qualified medical professional before making any changes to your treatment plan for endometriosis or any other health problems.
Orilissa is an oral GnRh drug that came out in 2018 by the same makers of Lupron. It has been approved by the FDA for the management of endometriosis symptoms for 6 months on the higher dose and 2 years on the lower dose. It can have serious side effects, and doesn’t diagnose, treat, remove, or shrink endometriosis lesions. Since it only came out in 2018, we still don’t have information on potential long-term side effects.
For many gynecologists, who are not endometriosis specialists and don’t often see patients with endometriosis in their practice, this (and/or Lupron) is the only “tool” they have for patients with endometriosis. GnRh drugs are supposed to be second-line therapies, meaning that they are prescribed when first-line therapies (oral contraceptive pills and progestins) are ineffective, not tolerated or contraindicated. Studies have shown that in about 2/3 of people with endometriosis, first-line therapies provide symptom relief.
Yet some doctors put their patients on GnRh drugs right away, as soon as they suspect endometriosis, and for much longer than the FDA approved time frame. Additionally, various studies comparing GnRh drugs to other hormonal medications such as the Mirena, Dienogest, Depo Provera, combined birth control pills, and others, have shown these other hormones (which a patient can be on for longer and that have a much lower side effect profile) to provide similar symptom relief to patients as GnRh drugs. This is another reason why GnRh drugs are second-line therapies, but unfortunately many gynecologists are giving them out as soon as they suspect endometriosis, without any conversation around the side effects, treatment time limitations, or equally viable options.
For More Info
- Endometriosis: Report-at-a-Glance – Report on Orilissa by ICER. “The Institute for Clinical and Economic Review (ICER) is an independent nonprofit research institute that produces reports analyzing the evidence on the effectiveness and value of drugs and other medical services.”
- OrilissaTM, a “significant advancement” for endometriosis patients – or another obstacle to quality care? – Article from Endo What.
- Elagolix for endometriosis: all that glitters is not gold. Paolo Vercellini, Paola Viganò, Giussy Barbara, Laura Buggio, Edgardo Somigliana, ‘Luigi Mangiagalli’ Endometriosis Study Group, Human Reproduction, Volume 34, Issue 2, February 2019, Pages 193–199, https://doi.org/10.1093/humrep/dey368
- Hormonal Therapy in Women of Reproductive Age with Endometriosis: An Update. – 2019 research article by Gheorghisan-Galateanu AA, Gheorghiu ML. Acta Endocrinol (Buchar). 2019;15(2):276-281. doi:10.4183/aeb.2019.276
- Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review – 2021 research article by Donnez J, Dolmans MM. J Clin Med. 2021;10(5):1085. Published 2021 Mar 5. doi:10.3390/jcm10051085