To mark International Women's Day and Endometriosis Awareness Month, Wellbeing of Women and the Scottish Government have awarded researchers in Scotland and England just over £250,000 to fund a clinical trial for a potential new treatment for endometriosis – the first for more than 40 years.
Researchers from the Universities of Edinburgh, Aberdeen and Birmingham will set up and run the clinical trial, called EPIC2, which will involve 100 women with endometriosis in Edinburgh and London. They will investigate whether a drug called dichloroacetate is an effective pain management treatment for those with the condition.
The team hopes this could lead to the first ever non-hormonal, non-invasive treatment for endometriosis.
Endometriosis affects 1.5 million women and those assigned female at birth in the UK. It occurs when tissue similar to the lining of the womb grows elsewhere in the body, most commonly in the pelvic area.
This tissue (known as endometriosis lesions) bleeds during a period but has nowhere to go – and causes inflammation, pain and the formation of scar tissue.
Earlier research, funded by Wellbeing of Women, discovered that cells from the pelvic wall of women with endometriosis behave differently compared to those without the condition.
Researchers from the University of Edinburgh found that these cells produce higher amounts of lactate, a chemical generated by the body to give us energy when there is a lack of oxygen. This creates an environment that supports the development and growth of endometriosis.
When these endometriosis cells were treated with dichloroacetate, a drug previously used to treat rare metabolic disorders in children, lactate production decreased to normal levels and the size of the endometriosis lesions were reduced.
The EPIC2 research team will build on this knowledge with their clinical trial to determine the optimum dose of dichloroacetate that will provide the most benefit, both in terms of tackling painful endometriosis symptoms and limiting side-effects.
In the EPIC2 clinical trial, which will start recruiting this autumn, half of the women will receive dichloroacetate while the other half will be given a placebo. These will be allocated at random and taken for 12 weeks.
Every woman will complete a series of questionnaires and give blood samples over the course of two-and-a-half-years.
In a move towards personalised medicine, the dose of dichloroacetate for each woman will be determined by which version of a gene called GSTZ1 they carry.
This gene is responsible for the speed at which dichloroacetate is metabolised by the body. Some variants do this more slowly than others, which could lead to a build-up of the drug in the bloodstream and increase the risk of side effects unless the dosage is tailored appropriately.