ENDOMETRIOSIS: ROLE OF DANAZOL VERSUS LETROZOLE FOR THE MANAGEMENT OF ENDOMETRIOSIS

Objective: Objective of this study is to compare the mean decrease in VAS pain score with Danazol versus Letrozole for the management of females presented with endometriosis. Study design: Randomized controlled trial. Setting: Department of Obstetrics and Gynaecology, Lady Wallington Hospital, Lahore. Duration of study: Six months after approval of synopsis.Patients and Methods: The sample size of 150 cases; 75 cases in each group is calculated with 95% confidence level, 80% power of test and taking expected mean+s.d of mean decrease in VAS pain score i.e. 0.26±1.968 with Lataterzaol and -1.61±2.4 with Danazol for the management of females presented with endometriosis. Sampling technique was Non probability, purposive sampling. Inclusion criteria was, females of age 20-40 years with diagnosis of endometeriosis. 150 females fulfilling inclusion criteria was registered through OPD of Lady Wallington Hospital, Lahore. Informed consent was taken. Demographic history including name, age, parity and duration of pain will also be obtained. Females was randomly divided in two groups through lottery method. Females in group A will receive treatment with Letrozole tablets (2.5 mg/day) from the third day of the first menstrual cycle. Females in group B will receive Danazol tablets (600 mg/day). Pelvic pain was assessed by using VAS score. Then females in each group was prescribed medication and followed up in OPD for 3 months. Pelvic pain after 3 months was again noted. All the information was collected on a specially designed proforma. All the collected data was entered into SPSS version 16 and analyzed through it. Variable like parity was presented as frequency distribution. Quantitative data like age, duration of pelvic pain and pain score before and after 3 months was presented as means and standard deviations. Mean decrease in pain score was calculated by subtracting post-treatment VAS pain score from pre-treatment VAS pain score. The two groups was compared for mean decrease in VAS pain score by using Student T-test. P-value < 0.05 was taken as significant. Data was stratified for the duration of pelvic pain to address the effect modifiers. Results:There were total 150 cases who were enrolled in this study. The mean age of the patients was 29.99±5.80. The mean pain score evaluated before the time of treatment was noted that was 4.44±1.73. After 3 months of treatment the mean pain score was 2.40±1.04 with a mean decrease in pain score of 20.4±1.54 (p-value=0.00). This difference in pain score was significantly different for the both treatment group. Conclusion: There is significant difference in mean decrease in pain score in both groups. Key words: Danazole, Letrozole, Endometriosis, Pelvic Pain