Dienogest vs. Leuprolide Asetat pada Endometriosis: Sebuah Meta-Analisis

Gilang Rizqy Perdana Aries Rohman; Lani Diana; Tatik Sujiati

doi:10.47507/obstetri.v9i2.249

Gilang Rizqy Perdana Aries Rohman Kusuma Hospital, Pamekasan
Lani Diana Kusuma Hospital, Pamekasan
Tatik Sujiati Kusuma Hospital, Pamekasan

DOI: https://doi.org/10.47507/obstetri.v9i2.249

Keywords: Analog GnRH, dienogest, endometriosis, leuprorelin asetat, progestin

Abstract

Latar Belakang: Endometriosis merupakan penyakit ginekologi kronis yang menyebabkan nyeri panggul dan menurunkan kualitas hidup. Dienogest diperkirakan memiliki efektivitas serupa dengan analog gonadotropin-releasing hormone (GnRH) seperti leuprolide asetat, namun dengan profil keamanan yang lebih baik.
Tujuan: Penelitian ini bertujuan membandingkan efektivitas dienogest dan leuprolide asetat dalam menurunkan nyeri panggul pada pasien endometriosis.
Subjek dan Metode: Systematic review dan meta-analisis dilakukan sesuai pedoman PRISMA terhadap RCT yang membandingkan dienogest dengan leuprolide asetat pada pasien endometriosis. Pencarian dilakukan di PubMed, ScienceDirect, dan Cochrane Library hingga 12 Februari 2025. Luaran utama adalah perubahan skor nyeri berdasarkan Visual Analog Scale (VAS).
Hasil: Enam RCT memenuhi kriteria inklusi. Dienogest menunjukkan penurunan nyeri panggul yang signifikan dibandingkan leuprolide asetat (MD 8,48 mm; 95% CI 2,33–14,63; p=0,007; I²=91%). Hot flush dan kekeringan vagina lebih sering terjadi pada kelompok leuprolide, sedangkan perdarahan terobosan lebih sering ditemukan pada kelompok dienogest.
Simpulan: Dienogest efektif dalam mengurangi nyeri panggul terkait endometriosis dengan profil keamanan yang lebih baik terhadap efek samping hipoestrogenik, sehingga berpotensi menjadi pilihan terapi jangka panjang.

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