Study Question: What is the efficacy and safety of long-term treatment (up to 2 years) with relugolix combination therapy (CT) in women with moderate to severe endometriosis-associated pain?
Summary Answer: For up to 2 years, treatment with relugolix CT improved menstrual and non-menstrual pain, dyspareunia, and function in women with endometriosis; after an initial decline of <1%, the mean bone mineral density (BMD) remained stable with continued treatment.
What Is Known Already: Endometriosis is a chronic condition characterized by symptoms of dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia, which have a substantial impact on the lives of affected women, their partners, and families. SPIRIT 1 and 2 were phase 3, randomized, double-blind, placebo-controlled studies of once-daily relugolix CT (relugolix 40 mg, oestradiol 1 mg, norethisterone acetate 0.
Problem: Medical schools are challenged to realign curricula to address society's needs in a rapidly changing environment, and to support new instruction and assessment methods that require substantial faculty time.
Approach: In 2010, the University of Michigan Medical school began planning the Global Health and Disparities Path of Excellence (GHD Path), an optional co-curriculum for students interested in health disparities, with explicit goals to (1) draw attention to the school's social mission; (2) test new, faculty-intensive methods of learning and assessment for all students; and (3) serve as a template for additional co-curricular paths.
Outcomes: Intended outcomes of the program include enhancing students' competency in leadership related to ameliorating health disparities and the study institution's ability to plan feasible and effective schoolwide reforms in self-directed learning, faculty advising systems, narrative-based feedback for goal setting, Web-based student portfolios, and additional Paths of Excellence.