OBJECTIVES: Endometriosis (EM) is a common ailment that affects approximately 10% of women of reproductive age in the US. The most frequent painful symptoms due to EM are dysmenorrhea, dyspareunia, and non-menstrual pelvic pain. Medications commonly used are over-the-counter (OTC) non-steroidal anti-inflammatory agents (NSAIDs) followed by hormone therapy, then, as needed, opioids. As new medications have recently become available, a retrospective review of analgesic prescribing patterns for the treatment of pain due to EM was warranted.

METHODS: A retrospective longitudinal study of administrative health plan claims, IQVIA’s PharMetrics® Plus, was used to identify women with newly diagnosed EM, some of whom had preexisting pain prior to index date, and, with up to 36 months of continuous enrollment pre- and post-index. The study period covered Oct 1, 2012, through Feb 28, 2022. For this real-world study of patients with EM, descriptive statistics of baseline demographics, including dysmenorrhea/dyspareunia and post-index pain treatment patterns were collected.

RESULTS: Of 23,834 subjects with an index diagnosis of EM, mean age was 42.8 years and the mean time from symptoms to diagnosis was 200 days. Key symptoms associated with the diagnosis were non menstrual pelvic pain (35.8%), and back pain (30.1%). Key symptoms associated with chronic opioid use were pelvic (27.7%) and back pain (27.3%). Of those with EM-related pain claims, 41.5% received an opioid; 8% meeting definition of persistent. Other medications commonly used included: hypnotics, sedatives, or anxiolytics (74.6%).

CONCLUSIONS: Limitations of data include inability to attribute pain to a specific condition and lack of OTC data capture (ie., OTC NSAID use). However, these data report frequent opioid use in women diagnosed with EM. With new oral agents approved for treatment of moderate-to-severe pain due to EM, further evaluation of OTC NSAID and opioid use is needed to support treatment decision making in this population.