Q: Professor Chapron, thank you for joining us. Let’s start with the basics: what is endometriosis exactly, and how many women are affected globally?
Prof. Charles Chapron: Endometriosis is a chronic and often painful condition where tissue found in the lining of the uterus grows outside of the uterus. Globally, around 190 million women are affected, which means 1 in 10 women of reproductive age lives with this condition globally.
Q: Those are staggering numbers. What are the typical symptoms?
CC: The most common symptoms include severely painful menstruation, chronic pelvic pain, pain during intercourse, and in some cases infertility. Often pain is labelled as normal, and patients get stuck in the diagnosis loop for several years before they receive the proper diagnosis for Endometriosis.
Q: On average, how long does it take to get diagnosed?
CC: On average, it takes 7 to 9 years from the onset of symptoms to arrive to a formal diagnosis. This delay is due to a combination of insufficient medical training, limited understanding of the uterine conditions, limited social awareness and cultural stigmas.
Q: That’s a significant gap. What are the currently available treatment options?
CC: We typically use a combination of symptom management including hormonal therapies, and in some cases, surgical intervention. The treatment is highly individualized, depending on the patients’ symptoms, age, and fertility goals. Among hormonal options, GnRH antagonists, such as Relugolix CT, have shown great promise in recent years.
Q: What makes Relugolix Combination Therapy (CT) different from other hormonal treatments?
CC: Relugolix binds to and inhibits GnRH receptors in the anterior pituitary gland, which reduces circulating FSH and LH – this in turn effectively lowers estradiol and progesterone levels. Estradiol alleviates symptoms associated with a hypoestrogenic state, such as vasomotor symptoms like hot flushes and bone mineral density loss. Norethisterone acetate mitigates the unopposed estrogen action that could lead to endometrial hyperplasia. Unlike older treatments requiring injections or implants, Relugolix CT is a combined once-daily oral tablet. Another key benefit is its reversibility – normal hormone levels return quickly after stopping treatment, which is especially important for women planning to conceive.
Q: Does Relugolix CT have solid clinical data supporting its effectiveness?
CC: Yes, the phase III Spirit trials of Relugolix CT, involving over 1,200 women, demonstrated that Relugolix CT significantly reduced both menstrual and non-menstrual pelvic pain. Over 60% of participants experienced reduction in pain within three months of consecutive use. At week 104 the NMPP score was maintained at 68,9% decreased from baseline. These results are very encouraging and support Relugolix CT as a reliable option for the long-term management of endometriosis related symptoms.
Q: Looking ahead, do you see a shift in how endometriosis is perceived and treated? Is Relugolix CT a game changer solution?
CC: Yes, absolutely. I would even say revolutionary! As for the illness itself: more and more countries are now recognizing endometriosis as a public health priority. At the same time the therapy is becoming available in more and more countries, fortunately. With earlier diagnosis and innovative treatments like Relugolix CT, we can dramatically improve the quality of life of millions of women. But we also need to change the narrative – menstrual pain should not be normalized when it is debilitating. Raising awareness and empowering women to speak up is just as important as medical innovation.
Q: Finally let me ask you about this year’s SEUD conference and the Gedeon Richter sponsored symposium, what are your main takeaways?
CC: They were successful, both the conference and the symposium. Attendance was extremely high. Besides, we received several interesting questions from the audience at the end of the GR symposium. For me, it also indicated the importance of this topic among the international gynaecologist society.