Plain language

Severe polycystic liver disease (PLD) occurs mostly in women, and liver cysts often grow with estrogen exposure and stabilize after menopause. This small open-label randomized trial tested whether lowering estrogen and progesterone with leuprorelin injections (every 3 months, inducing temporary menopause) would slow liver growth in premenopausal women aged 18–45 with severe PLD. Six women started leuprorelin immediately and eight received standard care with a delayed start planned at 18 months. At 18 months, liver volume had still increased in half of the women on leuprorelin, and the median annual liver growth rate was not statistically different from standard care (4.04% vs 11.0% per year). Quality of life did not improve, while menopausal side effects and adverse events were much more frequent with leuprorelin (38 vs 9 adverse events), leading the researchers to stop the trial early.

Clinical note

Prospective open-label randomized controlled trial (Hepatol Commun) in premenopausal women aged 18–45 years with severe PLD, randomized 1:1 to immediate leuprorelin 11.25 mg subcutaneously every 3 months (n = 6) vs standard care with delayed start at 18 months (n = 8). Primary outcome: liver growth rate at 18 months. At the 18-month interim analysis, liver volume still increased in 50% of the immediate-start arm, and median liver growth rate did not differ significantly between immediate leuprorelin and control (4.04%/year [-4.62 to 6.84] vs 11.0%/year [0.70 to 13.2], p = 0.15). PLD-related quality of life did not improve, one participant discontinued early for severe menopausal symptoms, and total adverse events were higher in the immediate-start arm (38 vs 9, p < 0.001), prompting early trial termination.

Question for your next visit

Do any hormonal medicines or contraceptives I use affect liver cysts in polycystic liver disease, and what options exist if liver cysts cause symptoms?

Plain language

Clinical note

Question for your next visit

See also