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The use of selective progesterone receptor modulators in the treatment of myomas


Authors: O. Šimetka;  J. Klát
Authors‘ workplace: Gynekologicko-porodnická klinika Fakultní nemocnice Ostrava, přednosta: doc. MUDr. Ondřej Šimetka, Ph. D., MBA
Published in: Ceska Gynekol 2016; 81(4): 317-320

Overview

Objective:
To summarize the knowledge of the effect of selective progesterone receptor modulators and their use in the treatment of myomas in women of childbearing age and in perimenopause.

Design:
Review article

Results:
Long-term treatment with ulipristal acetate maximizes its effectiveness, it helps to achieve faster bleeding control and increases the number of patients with fibroid volume reduction of more than 50%. Ulipristal acetate is the most effective drug in the medical treatment of myomas and its use will change the approach to surgical treatment.

Keywords:
myomas, medical therapy, surgical therapy, selective progesterone receptor modulators, ulipristal acetate


Sources

1. Courtoy, G. E., Donnez, J., Marbaix, E. et al. In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment. Fertil Steril, 2015, 104(2), p. 426-34.

2. Donnez, J., Arriagada, P., Donnez, O. et al. Current management of myomas: the place of medical therapy with the advent of selective progesterone receptor modulators. Curr Opin Obstet Gynecol, 2015, 27(6), p. 422-31.

3. Donnez, J., Tatarchuk, T. F., Bouchard, P. et al. Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med, 2012, 366(5), p. 409-20.

4. Donnez, J., Tomaszewski, J., Vazquez, F. et al. Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med, 2012, 366(5), p. 421-32.

5. Donnez, J., Vazquez, F., Tomaszewski, J. et al. Long-term medical management of uterine fibroids with ulipristal acetate. Fertil Steril, 2016, 105(1), p. 165-173.

6. Eisinger, S.H., Bonfiglio, T., Fiscella, K. et al. Twelve-month safety and efficacy of low-dose mifepristone for uterine myomas. J Minim Invasive Gynecol, 2005, 12(3), p. 227-33.

7. Luyckx, M., Squifflet, J. L., Jadoul, P. et al. First series of 18 pregnancies after ulipristal acetate treatment for uterine fibroids. Fertil Steril, 2014, 102(5), p. 1404-9.

8. Mára, M. , Holub, Z. Děložní myomy. Praha: Grada Publishing a.s., 2009.

9. Munro, M.G., Critchley, H. O., Broder, M. S. et al. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet, 2011, 113(1), p. 3-13.

10. Tsigkou, A., Reis, F. M., Lee, M. H. et al. Increased progesterone receptor expression in uterine leiomyoma: correlation with age, number of leiomyomas, and clinical symptoms. Fertil Steril, 2015, 104(1), p. 170-5.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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