SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Translational and Clinical Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1650579
This article is part of the Research TopicBeyond Contraception - Advancing Research and Innovations in Sexual and Reproductive Health to Better Meet the Needs of Women in Low-and Middle-Income CountriesView all 3 articles
Relugolix's Impact on Endometriosis-Associated Pain and Quality of Life: A Meta-Analysis of EHP-30 Outcomes
Provisionally accepted
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Background: Relugolix offers a promising alternative for endometriosis-associated pain, yet its comprehensive impact on health-related quality of life (HRQoL), particularly as measured by the disease-specific EHP-30 questionnaire, remains underexplored. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating relugolix for endometriosis-associated pain, with a primary focus on HRQoL assessed by the Endometriosis Health Profile-30 (EHP-30). Data extracted included EHP-30 domain scores changes and proportion of EHP-30 Pain Domain Responders, along with intervention details, control type, and follow-up duration. Results: Five RCTs were included. Overall, relugolix significantly improved EHP-30 Pain domain scores (MD = 6.77, 95% CI: 3.15 to 10.39, p=0.0002) but showed substantial heterogeneity (I²=90.7%). Subgroup analysis by control type showed significant differences (p<0.0001): Relugolix was highly effective against placebo (MD = 15.31, 95% CI: 12.18 to 18.45) and placebo-matching combination therapy (MD = 8.86, 95% CI: 5.03 to 12.69), but numerically less effective than leuprorelin (MD = -3.79, 95% CI: -6.27 to -1.31). Relugolix significantly increased EHP-30 Pain Domain Responders (OR = 3.245, 95% CI: 2.496; 4.219, p < 0.0001). For other EHP-30 domains, relugolix demonstrated significant improvements in Emotional Well-being (MD = 5.71, 95% CI: 1.87; 9.55, p=0.0036), Social Support (MD = 6.40, 95% CI: 0.88; 11.93, p=0.0231), and Self-image (MD = 6.00, 95% CI: 1.03; 10.96, p=0.0179) compared to placebo. Conclusion: Oral relugolix significantly improves EHP-30 pain domain scores and patient response rates in endometriosis, particularly when compared to placebo. It also positively impacts emotional well-being, social support, and self-image.
Keywords: Endometriosis, relugolix, GnRH antagonist, Quality of Life, EHP-30, Pain, Systematic review, Meta-analysis
Received: 20 Jun 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Xie, Ni, Huang and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ying Guo, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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