Dr. Dawn Carlson is AbbVie’s Vice President of General Medicine Development and is a twenty-year veteran of AbbVie and Abbott. She received her bachelor of science in Microbiology from the University of Illinois at Urbana-Champaign, followed by her MD at the University of Illinois College of Medicine. Dr. Carlson also received a Masters of Public Health at Johns Hopkins Bloomberg School of Health in Epidemiology and Biostatistics..
Endometriosis affects an estimated one in 10 women and is associated with debilitating pain symptoms and increased financial burden to patients and the health care system. Dr. Dawn Carlson shares how the biopharmaceutical industry is making an impact on the diagnosis and treatment of a disease that has not seen innovation in decades.
Count ten women on a crowded street or in a meeting room, and it’s probable that at least one of them is living with a chronic and painful disease that has no cure. Although their symptoms are not visible on the outside, these women are suffering physically, mentally and socially from a disease whose impact is not well recognized or widely discussed – it’s called endometriosis.
Endometriosis affects an estimated one in ten women and is the third leading cause of gynecologic hospitalization in the U.S. Despite these facts, there is a lack of awareness and prioritization of endometriosis as an important women’s health issue. Endometriosis is also a problem for the health care system – recent data suggest that the disease is associated with increased health care costs and substantial financial burden to patients.
Endometriosis occurs when tissue similar to that normally found in the uterus begins to grow outside of the uterus. These misplaced growths, or lesions, can grow on the ovaries, fallopian tubes and other areas around the pelvis, which may lead to long-term pelvic pain (during or between periods), pain with intercourse or other debilitating symptoms depending on the location of the lesions.
Endometriosis most often affects women of reproductive age, and therefore symptoms can have devastating effects during what should be some of a woman’s most productive years for education, career development, building relationships and having children. Endometriosis not only affects the woman with the disease, but also her partners, friends and family.
“I look forward to a day when women with endometriosis can be diagnosed definitively with a clinical history and examination in combination with a simple blood test, avoiding the need for invasive procedures or empiric treatment.”
Diagnosis is often delayed – women can suffer up to six to ten years before learning what is causing their symptoms and may require a surgical procedure. Currently there are no widely accepted biomarkers for endometriosis and physicians have limited options to offer patients for the long-term medical management of endometriosis-associated pain. Treatment options include oral contraceptives, pain medications (from NSAIDs to opioids), hormonal therapies, and GnRH agonists, many of which are not specifically indicated to treat endometriosis. Women may also endure repetitive and costly surgical procedures for symptom relief, which may not be curative.
Endometriosis has not seen meaningful innovation in decades, but the pharmaceutical industry is making great strides to help this underserved population of women. While there are many theories as to the etiology of endometriosis, we still don’t know definitively why it develops. Biopharmacuetical researchers are leading the charge to better understand the mechanisms of endometriosis so that improved interventions can be developed.
Several treatment options for the management of endometriosis-associated pain are in late-stage clinical trials and data suggests these treatments could reduce the daily menstrual and non-menstrual pelvic pain associated with endometriosis.
In addition to discovering new treatment options, the biopharma industry is collaborating with scientists and academia to develop alternative approaches to diagnosis. I look forward to a day when women with endometriosis can be diagnosed definitively with a clinical history and examination in combination with a simple blood test, avoiding the need for invasive procedures or empiric treatment.
As a physician in the biopharmaceutical industry, I have had the opportunity to work on multiple projects that targeted improving the symptoms of patients with diseases for which optimal therapies were not available. The common thread is that all were aimed at developing therapies that could have remarkable impact on the lives of patients with diseases with significant unmet needs. Women with endometriosis endure years of suffering and are faced with suboptimal therapeutic choices. It is gratifying to know that in my role leading a clinical research development team, I play a part in finding a way to improve their discomfort with a well-studied alternative. I am also proud to be part of an industry seeking solutions that can help women with endometriosis find relief and an improved quality of life.
Dawn Carlson, M.D., M.P.H., is the Vice President of General Medicine Development at AbbVie. Previously, she held various roles at AbbVie and led oncology, Humira rheumatology and dermatology development teams.
- McLeod BS, Retzloff MG. Epidemiology of endometriosis: an assessment of risk factors. Clinical Obstetrics and Gynecology. 2010;53(2):389-396.
- Soliman AM, Yang H, Du EX, Kelley C, Winkel C. The direct and indirect costs associated with endometriosis: a systematic literature review. Human Reproduction (Oxford, England). 2016;31(4):712-722.
- Cramer DW, Missmer SA. The epidemiology of endometriosis. Annals of the New York Academy of Sciences. 2002;955:11-22; discussion 34-16, 396-406.American Society for Reproductive Medicine, The Society of
- Reproductive Surgeons. Patient Fact Sheet: Managing Pelvic Pain In: American Society for Reproductive Medicine, ed. Birmingham, Alabama 2008.
- Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362(25):2389-2398.
- Silverberg KM, Olive DL. Textbook of Gynecology. 2nd ed. Philadelphia, PA: WB Saunders; 2000.
- The American College of Obstetricians and Gynecologists. ACOG Education Pamphlet AP013: Endometriosis. Washington, DC 2008.
- Mayo Clinic. Diseases and Symptoms: Endometriosis Fact Sheet. 2016; http://www.mayoclinic.org/diseases-conditions/endometriosis/basics/symptoms/con-20013968. Accessed February 1, 2016.
- Kavoussi SK, Lim CS, Skinner BD, Lebovic DI, As-Sanie S. New paradigms in the diagnosis and management of endometriosis. Current Opinion in Obstetrics & Gynecology. 2016;28(4):267-276.
- Mayo Clinic. Diseases & Conditions: Endometriosis Fact Sheet. 2016; http://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/treatment/txc-20236449. Accessed Febrary 1, 2016.
- Guo SW. Recurrence of endometriosis and its control. Human Reproduction Update. 2009;15(4):441-461.
- Greene AD, Lang SA, Kendziorski JA, Sroga-Rios JM, Herzog TJ, Burns KA. Endometriosis: where are we and where are we going? Reproduction (Cambridge, England). 2016;152(3):R63-78.
- Melis GB, Neri M, Corda V, et al. Overview of elagolix for the treatment of endometriosis. Expert Opin Drug Metab Toxicol. 2016;12(5):581-588.
- Tafi E, Leone Roberti Maggiore U, Alessandri F, et al. Advances in pharmacotherapy for treating endometriosis. Expert Opin Pharmacother. 2015;16(16):2465-2483.
- Bedaiwy MA, Alfaraj S, Yong P, Casper R. New developments in the medical treatment of endometriosis. Fertility and Sterility. 2017;107(3):555-565.