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Generic substitute for tamoxifen in the treatment of early endometriosis. In a randomized, controlled trial, we found a higher rate of progression toward early endometriosis in the group receiving natalizumab (1,700-1,800 mg/month) compared with placebo in the first year and then to placebo over a total followup of 8.5 years, with an overall rate of progression to early endometriosis 21.5 % (95% CI = 15-30 %) in the natalizumab group compared to 15.0 % (95% CI = 7.5-21 %) in placebo, for an adjusted odds ratio (OR) of 0.60 (95% CI = 0.42-0.88). This study has important clinical and public health implications. INTRODUCTION Early endometriosis is characterized by abnormal vaginal epithelial cells with a thickened, fibrous lining composed of noncytotoxic cells with multiple stromal layers; endometrial lesions may occur anywhere from the cervix to ovaries (1). Early endometriosis may progress to epithelial hyperplasia, but it can progress to the more advanced tamoxifen generic uk disease endometriosis with endometrial cancer. Women with endometriosis typically develop an ovarian response that is characterized by infertility, menstrual irregularities, or a decreased likelihood of conception (2-5). Although the long-term prognosis for women with endometriosis is poor, a clinical response to treatment can occur and this response seems to improve as women progress through the disease (6). Natalizumab, an immunosuppressant, inhibits the effects of TNF on endometrial development, causing a decrease in inflammatory mediators <$%INSIDE_LINK_1%$> such as interleukin (IL)-6 and IL-10 increases levels of anti-inflammatory cytokines such as IL-10 (7). In a randomized, double-blinded, placebo-controlled trial of natalizumab in the management postpartum endometriosis, we report a higher progression rate in the natalizumab arm over a period of 1 buy generic tamoxifen citrate year in the early stages of disease. This trial is the only study to address this issue in the management of early endometriosis. MATERIALS AND METHODS Participants Women with severe, early stage pelvic inflammatory disease (PIDD) who sought treatment with an intrauterine device (IUD) or in an outpatient clinic were eligible for inclusion in this study. The final screening criteria were confirmed by a physician who the diagnosis of PIDD (7). Women could start natalizumab at the time that her PIDD was identified. Women <$%INSIDE_LINK_0%$> who chose a nonhormonal IUD and were using natalizumab eligible for inclusion. After an initial screening visit, participants were invited to return for.

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