{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:32:21Z","timestamp":1792809141808,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: The aim of the present pilot study was to study the effect of a new oral gonadotropin-releasing hormone antagonist on adenomyosis. (2) Methods: Eight premenopausal women, aged between 37 and 45 years, presenting with heavy menstrual bleeding, pelvic pain, and dysmenorrhea due to diffuse and disseminated uterine adenomyosis, confirmed by magnetic resonance imaging (MRI), received 200 mg linzagolix once daily for a period of 12 weeks, after which they were switched to 100 mg linzagolix once daily for another 12 weeks. The primary efficacy endpoint was the change in volume of the adenomyotic uterus from baseline to 24 weeks, evaluated by MRI. Secondary efficacy endpoints included the change in uterine volume from baseline to 12 and 36 weeks by MRI, and also weeks 12, 24, and 36 assessed by transvaginal ultrasound (TVUS). Other endpoints were overall pelvic pain, dysmenorrhea, non-menstrual pelvic pain, dyspareunia, amenorrhea, quality of life measures, bone mineral density (BMD), junctional zone thickness, and serum estradiol values. (3) Results: Median serum estradiol was suppressed below 20 pg\/mL during the 12 weeks on linzagolix 200 mg, and maintained below 60 pg\/mL during the second 12 weeks on linzagolix 100 mg. At baseline, the mean \u00b1 SD uterine volume was 333 \u00b1 250 cm3. After 24 weeks of treatment, it was 204 \u00b1 126 cm3, a reduction of 32% (p = 0.0057). After 12 weeks, the mean uterine volume was 159 \u00b1 95 cm3, a reduction of 55% from baseline (p = 0.0001). A similar pattern was observed when uterine volume was assessed by TVUS. Improvements in overall pelvic pain, dysmenorrhea, non-menstrual pelvic pain, dyspareunia, and dyschezia, as well as quality of life measured using the EHP-30 were also observed. Mean percentage BMD loss at 24 weeks was, respectively, \u22122.4%, \u22121.3%, and \u22124.1% for the spine, femoral neck, and total hip. The most common adverse events were hot flushes, which occurred in 6\/8 women during the first 12 weeks, and 1\/8 women between 12 and 24 weeks. (4) Conclusions: Linzagolix at a dose of 200 mg\/day reduced uterine volume, and improved clinically relevant symptoms. Treatment with 100 mg thereafter retains the therapeutic benefits of the starting dose while minimizing side effects. This \u2018hit hard first and then maintain\u2019 approach may be the optimal way to treat women with symptomatic adenomyosis.<\/jats:p>","DOI":"10.3390\/jcm10245794","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T01:28:11Z","timestamp":1639358891000},"page":"5794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Uterine Adenomyosis Treated by Linzagolix, an Oral Gonadotropin-Releasing Hormone Receptor Antagonist: A Pilot Study with a New \u2019Hit Hard First and then Maintain\u2019 Regimen of Administration"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2528-206X","authenticated-orcid":false,"given":"Jacques","family":"Donnez","sequence":"first","affiliation":[{"name":"Medical School, Universit\u00e9 Catholique de Louvain, 1200 Brussels, Belgium"},{"name":"Soci\u00e9t\u00e9 de Recherche pour l\u2019infertilit\u00e9 (SRI), 143 Avenue Grandchamp, 1150 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2388-8973","authenticated-orcid":false,"given":"Olivier","family":"Donnez","sequence":"additional","affiliation":[{"name":"Polyclinique Urbain V (ELSAN Group), Institut du Sein et de Chirurgie Gyn\u00e9cologique d\u2019Avignon, 84000 Avignon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Tourniaire","sequence":"additional","affiliation":[{"name":"Clinique Rh\u00f4ne Durance (ELSAN Group), Department of Radiology, 84000 Avignon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Brethous","sequence":"additional","affiliation":[{"name":"ObsEva SA, 1228 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Bestel","sequence":"additional","affiliation":[{"name":"ObsEva SA, 1228 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Garner","sequence":"additional","affiliation":[{"name":"ObsEva Inc., Boston, MA 02101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Charpentier","sequence":"additional","affiliation":[{"name":"ObsEva SA, 1228 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Humberstone","sequence":"additional","affiliation":[{"name":"ObsEva SA, 1228 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Loumaye","sequence":"additional","affiliation":[{"name":"ObsEva SA, 1228 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/0002-9378(72)90781-8","article-title":"The elusive adenomyosis of the uterus","volume":"112","author":"Bird","year":"1972","journal-title":"Am. 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