A Cochrane review «Gonadotropin‐releasing hormone analogues for endometriosis»1 «Veth VB, van de Kar MM, Duffy JM, et al. Gonadotropin-releasing hormone analogues for endometriosis. Cochrane Database Syst Rev 2023;6(6):CD014788 »1 included 72 studies with a total of 7355 subjects. Gonadotrophin-releasing hormone analogues (GnRHas) compared with placebo were more effective at symptom relief at three months in 1 trial (n=87), reported as pelvic pain scores (RR 2.14; 95% CI 1.41 to 3.24, dysmenorrhoea scores (RR 2.25; 95% CI 1.59 to 3.16, and pelvic tenderness scores (RR 2.28; 95% CI 1.48 to 3.50. More adverse events were reported in the GnRHa group. There was no statistically significant difference between GnRHas and danazol in 1 small trial.
Comment: The quality of evidence is downgraded by risk of bias (unclear allocation concealment or blinding in half of the studies) and by imprecise results.