Effect of disease-modifying anti-rheumatic drugs on therapeutic outcomes among women with endometriosis

Endometriosis is a gynecologic condition that affects approximately 5–15% women of reproductive age in the USA. Number of previous studies reported the use of disease-modifying anti-rheumatic drugs (DMARDs) against endometriosis, but none of them showed the significant result. Therefore the findings of this retrospective study suggest that administration of DMARDs for at least six weeks is associated with decreased opioid usage among women with endometriosis.

To discover whether disease-modifying anti-rheumatic drugs (DMARDs) influence the effectiveness of hormonal treatments, subsequent ablative surgery, and demand for pain management, involving non-steroidal anti-inflammatory drugs, anti-depressants, and opioids in females with endometriosis.

Females with surgically verified endometriosis who were not treated or treated with DMARDs for six weeks or more prior to surgical diagnosis between 2003 and 2013 at a single healthcare system in the USA were reviewed to retrieve the data. Both groups were compared for postoperative use of hormonal treatments, the performance of adjunct therapies such as steroids, opioids, and antidepressants prior to the surgery, and the proportion of females going through subsequent ablative surgery. 

A difference in follow-up time and age was seen between the groups. The females treated with DMARDs required more antidepressants and hormonal treatments. The incidence of the post-diagnostic utility of opioids was reduced in the treated females; this relationship remained vital in multivariate analysis.

The outcomes recommend that introduction of DMARDs for at least 6 weeks is linked with reduced opioid usage in the females with endometriosis.