Is effective treatment of endometriosis with NSAIDs dependent on personalized medicine (A Systematic Review)

Introduction: Endometriosis is one of the most common diseases, which is characterized by the occurrence of ectopic foci of endometrial tissue growth in the pelvic cavity. There are various treatments for symptomatic endometriosis that can act through various mechanisms such as inhibition of ovulation and anti-inflammatory therapies. Common treatments include surgery and hormonal treatment with limitations such as the risk of recurrence of disease, complications, and rising costs. Thus, we are looking for appropriate treatment for each person with the least cost and cost to prevent the progression of the disease, and according to the nature of the disease, drug therapies such as NSAIDs, GnRH, selective progesterone (or estrogen) modulators, aromatase inhibitor has been used.Methods: We searched articles in the PubMed, Google Scholar and Science Direct databases from 2015 to January 2019. About 35 articles were found; of these, 10 articles related to our study that were investigated.Results: Inflammatory factors play an important role in inflammation and pain in endometriosis. One of these factors can be the prostaglandin products and metabolism (PGE2, PGE2 synthase, cyclooxygenase-2), Proinflammatory cytokine and chemokine, TNF-α. Thus, reducing inflammation can prevent the progression of the disease. Therefore, the first step is the use of NSAIDs that have anti-inflammatory and analgesic properties by inhibiting cyclooxygenase, but the results are obtained in approximately 50 % Of patients have failed.Conclusion: It is hoped that using genomes study and medical findings, we can have effective treatment to reduce the side effect and the cost of treatment associated with the disease.

Keywords:

Endometriosis , NSAID , anti-inflammatory drug , Personalized Medicine