LNG-IUS vs. medical treatments for women with heavy menstrual bleeding: A systematic review and meta-analysis

Bibliographic Details
Title: LNG-IUS vs. medical treatments for women with heavy menstrual bleeding: A systematic review and meta-analysis
Authors: Sijing Chen, Jianhong Liu, Shiyi Peng, Ying Zheng
Source: Frontiers in Medicine, Vol 9 (2022)
Publisher Information: Frontiers Media S.A., 2022.
Publication Year: 2022
Collection: LCC:Medicine (General)
Subject Terms: levonorgestrel-releasing intrauterine system, LNG-IUS, heavy menstrual bleeding, systematic review, meta-analysis, Medicine (General), R5-920
More Details: IntroductionTo compare efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) with medical treatments for women with heavy menstrual bleeding.Materials and methodsWe searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), and Wanfang databases for relevant randomized controlled trials (RCTs) in November 2021. All meta-analyses were performed using the random-effects model. PROSPERO registration number: CRD42021295379.ResultsA total of trials (with 14 references) reporting on 1,677 women were included in this systematic review. The majority of the included RCTs were rated with low-to-unclear risk of bias in selection, detection, attrition, reporting, and other bias. All RCTs were rated as high risk in performance bias because blinding was difficult to ensure in the compared groups. Results of meta-analyses revealed that the number of clinical responders was greater in the LNG-IUS group than that in the medical treatments group at both 6-month (steroidal: five RCTs; n = 490; risk ratio [RR]: 1.72 [1.13, 2.62]; I2 = 92%; nonsteroidal: one RCT; n = 42; RR: 2.34 [1.31, 4.19]) and 12-month (steroidal: three RCTs; n = 261; RR: 1.31 [1.01, 1.71]; I2 = 74%) endpoints, with no clear differences on number of dropouts, and the incidence of adverse events.ConclusionEvidence indicates that LNG-IUS is superior to the medical treatments in short-term and medium-term clinical responses, blood loss control, compliance, and satisfaction. Meanwhile, frequency of adverse events related to LNG-IUS is acceptable.Systematic review registrationPROSPERO, identifier CRD42021259335, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021295379.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-858X
Relation: https://www.frontiersin.org/articles/10.3389/fmed.2022.948709/full; https://doaj.org/toc/2296-858X
DOI: 10.3389/fmed.2022.948709
Access URL: https://doaj.org/article/5e8cdc60bd3b4cdd8d61bc3814c66ed1
Accession Number: edsdoj.5e8cdc60bd3b4cdd8d61bc3814c66ed1
Database: Directory of Open Access Journals
More Details
ISSN:2296858X
DOI:10.3389/fmed.2022.948709
Published in:Frontiers in Medicine
Language:English