Elagolix, טיפול יעיל לסובלות מאנדומטריוזיס

אנדומטריוזיס מתאפיינת בהתנחלות של רירית הרחם אל מחוץ לחלל האיבר לאזורים בתוך חלל הבטן שבאופן תקין לא מארחים אותה. אנדומטריוזיס היא בעיה שכיחה ומופיעה בכ 5-10% אחוז מנשים בגיל הפוריות. נדידת הרירית אל מחוץ לחלל הרחם גורמת לדימומים בחלל הבטן, כאבי בטן עזים בעת הווסת, כאבים בקיום יחסי מין, שיבוש איכות החיים וקושי ביכולת הנשים להכנס להריון. אופי הטיפול באנדומטריוסיס תלוי בחומרת התופעה והשלכותיה וכולל תרופות נוגדות כאבים ודלקות, טיפול בגלולות למניעת הריון, טיפולים הורמונליים (שחלקם ניתנים בזריקות) ובמקרים קשים אף טיפולים נתוחיים.

להורמון אסטרוגן, שמופרש מהשחלות, יש תפקיד מרכזי בשגשוג רירית הרחם ולכן תרופות שגורמות לדיכוי הפרשת אסטרוגן תדכאנה את שגשוג הרירית ותצמצמנה את הדימום בחלל הבטן של נשים הסובלות מאנדומטריוזיס. לאחרונה, פיתחה חברת AbbVie תרופה בשם Elagolix הניטלת דרך הפה ומשבשת את ייצור האסטרוגן על ידי דכוי הפרשתם של הורמונים מבלוטת יותרת המוח החיוניים להפרשת אסטרוגן מהשחלות.

ב 19.5.17 פרסם העיתון הרפואי היוקרתי New England Journal of Medicine תוצאות מחקרים שבדקו את השפעת Elagolix על כאבי המחזור, כאבי בטן ומדדים נוספים בנשים הסובלות מאנדומטריוזיס עם תופעות בינוניות עד קשות בעת המחזור. המחקרים מצביעים כי Elagolix, שניתנה לנשים במינון מתון של 150 מג׳ ליום או במינון מוגבר של 400 מג׳ ליום, גרמה לצמצום כאבי המחזור וכאבי הבטן ב 43% עד 75% מהנשים שנטלו את התרופה. החוקרים דווחו כי Elagolix היתה יעילה יותר מפלצבו, תרופות נוגדות כאב ודלקת ותרופות אחרות לטיפול באנדומטריוזיס. כצפוי, דכוי הפרשת האסטרוגן גררה בעקבותיה גלי חום, שיבוש במשק השומנים בדם ושיבוש בצפיפות העצם. למרות שמספר נשים נכנסו להריון תחת הטיפול ב Elagolix, מוקדם עדיין לקבוע את השפעת הטיפול על הכניסה להריון.

תרופות יעילות הניתנות דרך הפה צפויות להציג יתרון ניכר בטיפול באנדומטריוזיס. Elagolix אינה משווקת עדיין בישראל או בארצות הברית ויש להמתין ולראות אם רשות המזון והתרופות בארצות הברית (FDA) תאשר את השימוש בתרופה בעתיד הקרוב.

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