Effects of the GnRH agonist leuprorelin on liver volume in premenopausal women with severe polycystic liver disease.
7 affiliations
- 1Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 2Department of Gastroenterology and Hepatology, Radboudumc, Nijmegen, The Netherlands.
- 3Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 4Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 5Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 6Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- 7Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Abstract
Background
Polycystic liver disease (PLD) is characterized by multiple liver cysts, sometimes leading to severe liver enlargement, with associated physical and psychosocial complaints. Treatment options are limited. Female gender is a risk factor for PLD; estrogen supplementation increases liver size in women with PLD, whereas the polycystic liver decreases after menopause. Estrogens may therefore be a target for therapy.Methods
In this prospective, open-label study, premenopausal women aged 18-45 years with severe PLD were randomized 1:1 to a direct start of the gonadotropin-releasing hormone agonist leuprorelin (n=6) or to standard care with delayed start of leuprorelin 18 months after randomization (n=8). The gonadotropin-releasing hormone agonist (11.25 mg injections once every 3 mo) leads to a reduction in estrogens and progesterone, and consequently to medically induced menopause. The primary outcome was liver growth rate at 18 months. Secondary outcomes comprised quality of life, menopausal side effects, and adverse events. An interim analysis was performed when all participants had reached month 18, as notable side effects were expressed.Results
In the group with direct start of leuprorelin, liver volume still increased in half of the participants, with the median liver growth rate not significantly different from the standard care group (4.04 [-4.62 to 6.84] vs. 11.0 [0.70-13.2] %/year, respectively, p=0.15). Importantly, PLD-related quality of life did not improve with treatment, whereas menopausal side effects were severe, leading one participant to stop treatment early. The total number of adverse events in the direct versus standard care group was 38 versus 9, respectively (p<0.001). Because of these results, the study was terminated early.Conclusions
leuprorelin treatment did not reverse liver volume, while menopausal side effects and adverse events were substantial.
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BibTeX
@article{wijbenga2026effects,
title = {{Effects of the GnRH agonist leuprorelin on liver volume in premenopausal women with severe polycystic liver disease.}},
author = {Inge G Wijbenga and Renee Duijzer and Paul Geertsema and Sophie E Aapkes and Thomas Bais and Lianne A Messchendorp and Priya Vart and Robbert J de Haas and Marjan van den Berg and Hans Blokzijl and Astrid E P Cantineau and Maatje D A van Gastel and Joost P H Drenth and DrenthRon T Gansevoort},
journal = {Hepatology communications},
year = {2026},
month = oct,
doi = {10.1097/hc9.0000000000001067},
url = {https://europepmc.org/article/MED/42900154},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of the GnRH agonist leuprorelin on liver volume in premenopausal women with severe polycystic liver disease.
AU - Inge G Wijbenga
AU - Renee Duijzer
AU - Paul Geertsema
AU - Sophie E Aapkes
AU - Thomas Bais
AU - Lianne A Messchendorp
AU - Priya Vart
AU - Robbert J de Haas
AU - Marjan van den Berg
AU - Hans Blokzijl
AU - Astrid E P Cantineau
AU - Maatje D A van Gastel
AU - Joost P H Drenth
AU - DrenthRon T Gansevoort
PY - 2026
DA - 2026/10/19
JO - Hepatology communications
DO - 10.1097/hc9.0000000000001067
UR - https://europepmc.org/article/MED/42900154
AB - Background Polycystic liver disease (PLD) is characterized by multiple liver cysts, sometimes leading to severe liver enlargement, with associated physical and psychosocial complaints. Treatment options are limited. Female gender is a risk factor for PLD; estrogen supplementation increases liver size in women with PLD, whereas the polycystic liver decreases after menopause. Estrogens may therefore be a target for therapy.Methods In this prospective, open-label study, premenopausal women aged 18-45 years with severe PLD were randomized 1:1 to a direct start of the gonadotropin-releasing hormone agonist leuprorelin (n=6) or to standard care with delayed start of leuprorelin 18 months after randomization (n=8). The gonadotropin-releasing hormone agonist (11.25 mg injections once every 3 mo) leads to a reduction in estrogens and progesterone, and consequently to medically induced menopause. The primary outcome was liver growth rate at 18 months. Secondary outcomes comprised quality of life, menopausal side effects, and adverse events. An interim analysis was performed when all participants had reached month 18, as notable side effects were expressed.Results In the group with direct start of leuprorelin, liver volume still increased in half of the participants, with the median liver growth rate not significantly different from the standard care group (4.04 [-4.62 to 6.84] vs. 11.0 [0.70-13.2] %/year, respectively, p=0.15). Importantly, PLD-related quality of life did not improve with treatment, whereas menopausal side effects were severe, leading one participant to stop treatment early. The total number of adverse events in the direct versus standard care group was 38 versus 9, respectively (p<0.001). Because of these results, the study was terminated early.Conclusions leuprorelin treatment did not reverse liver volume, while menopausal side effects and adverse events were substantial.
SN - 2471-254X
ER -