Comparing the effect of aromatase inhibitor (letrozole) + cabergoline (Dostinex) and letrozole alone on uterine myoma regression,a randomized clinical trial

Sayyah-Melli, Manizheh; Mobasseri, Majid; Gharabaghi, Parvin Mostafa; Ouladsahebmadarek, Elaheh; Rahmani, Vahideh

doi:10.1016/j.ejogrb.2016.11.001

Cited by 8 publications

(10 citation statements)

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“…What is even more interesting, the side effects were mild (mostly hot flashes), and no significant effects were observed on lipid profiles and steroid serum levels [ 121 ]. Similar results were obtained by Sayyah-Melli et al [ 122 ], who mixed letrozole with cabergoline. In their study, 12 weeks of treatment with letrozole with and without cabergoline improved the size and volume of UFs without significant differences between the study groups.…”

Section: Discussionsupporting

confidence: 90%

“…In their study, 12 weeks of treatment with letrozole with and without cabergoline improved the size and volume of UFs without significant differences between the study groups. Both groups were comparable for the remaining minor side effects [ 122 ]. In an interesting study from 2014, administration of letrozole and norethindrone acetate in patients with large UFs decreased the mean operative time by 13 min, intraoperative blood loss by 190 mL, and suturing time by 10 min during laparoscopic myomectomy as compared to placebo controls [ 123 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, cabergoline presented a safer pharmacological profile, with fewer adverse drug reactions [ 127 ]. In another study, also conducted by Sayyah-Melli, cabergoline was added as a co-drug to letrozole to evaluate its synergic effect in UF therapy [ 122 ]. In this study, the addition of cabergoline did not significantly change the drop in UF volume, but caused more women to report a headache as an adverse reaction [ 101 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

Ciebiera

Łukaszuk

Męczekalski

et al. 2017

IJMS

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Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

Ciebiera

Łukaszuk

Męczekalski

et al. 2017

IJMS

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“…Aromatase inhibitors have demonstrated usefulness in reducing fibroid volume. 135,136 This medication class works by inhibiting aromatase, a cytochrome p450 enzyme, which blocks the conversion of androgens to estrogens. 127 Aromatase inhibitors appear to be as or more effective than GnRH agonists at reducing fibroid volume but have significantly fewer adverse effects when used short term.…”

Section: Aromatase Inhibitorsmentioning

confidence: 99%

The Effect of Uterine Fibroids on Infertility: A Systematic Review

2017

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Fibroids are present in up to 27% of patients seeking reproductive assistance, and can affect fertility through cavity distortion, alteration of endometrial receptivity, and sexual function. Surgical, noninvasive, and medical approaches have been developed to manage fibroids, but evidence-based data regarding their safety and efficacy for the treatment of infertility and the effects on pregnancy outcome are limited. Myomectomy, through minimally invasive techniques, is the most evidence-based approach to fibroids in women planning conception, and increases pregnancy rates by up to 68% in previously infertile patients. Laparoscopic uterine artery occlusion is under investigation as an alternative and simpler surgical approach to decrease fibroid size. Uterine artery embolization is not recommended for women intending future pregnancy, as the rate of spontaneous abortion (SAB) is up to 64% and the rate of abnormal placentation is 12.5%. Magnetic resonance imaging–guided focused ultrasound surgery is gaining interest as a noninvasive procedure with positive preliminary pregnancy outcomes, but appears to have an SAB rate of 20.6%. Selective progesterone receptor modulators, aromatase inhibitors, and vitamin D supplementation are under investigation to improve uterine conditions for pregnancy. Submucosal and intramural fibroids affect fertility and pregnancy outcomes and should be addressed during infertility workup.

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“…В слу-чае имеющегося у пациентки эндометриоза препараты вышеназванной группы подавляют действие ароматазы, содержание которой по-вышается при данной патологии, чем достига-ется не только лечебный эффект в отношении эндометриоидных гетеротопий, но и улучшает-ся рецептивность эндометрия [55,56]. Также было отмечено, что при применении летрозола у пациенток с миомой матки происходит зна-чительное уменьшение объема миоматозных узлов [57].…”

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Aromatase inhibitors in “poor” ovarian responders undergoing in vitro fertilization

Merkulova

Игоревна²

2017

Z.akus.zen.bolezn

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■ Проблема «слабого» ответа яичников на стимуляцию существует с момента начала широкого применения экс-тракорпорального оплодотворения (ЭКО) с целью лечения бесплодия. От 9 до 25 % циклов ЭКО сопровождается недостаточной ответной реакцией яичников на вводимые извне гонадотропины. В опубликованной за последние годы литературе описано большое количество методов преодоления «слабого» ответа, но результаты исследо-вания их эффективности противоречивы, а единого подхода к выбору оптимального алгоритма лечения нет. В статье описываются возможные пути реализации лечебного действия ингибиторов ароматазы у пациенток со «слабым» ответом на стимуляцию. ■ Ключевые слова: стимуляция овуляции; ЭКО; «слабый» ответ; ингибиторы ароматазы. AROMATASE INHIBITORS IN "POOR" OVARIAN RESPONDERS UNDERGOING IN VITRO FERTILIZATION © A.I. MerkulovaSt Petersburg State University, Saint Petersburg, Russia ■ Since the IVF treatment expands worldwide, it has become apparent that a proportion of women responds suboptimally to controlled ovarian stimulation with exogenous gonadotrophins. There is still no consensus on the ideal controlled ovarian stimulation protocol for patients with "poor" ovarian response. Many strategies have been studied. However, no compelling advantage for one treatment protocol over another has been identified. The addition of aromatase inhibitors in "poor" responders stimulation protocols is described in this article.■ Keywords: ovarian stimulation; IVF; poor ovarian response; aromatase inhibitors.По мере того как экстракорпоральное опло-дотворение (ЭКО), как метод лечения беспло-дия, получало все более широкое распростра-нение, все более очевидным становилось то, что далеко не во всех случаях стимуляции супер-овуляции ответ яичников на вводимые извне гонадотропины является оптимальным [1, 2]. По различным данным, частота встречаемости этой проблемы в программах вспомогательных репродуктивных технологий (ВРТ) составляет от 9 до 25 %, и с каждым годом она увеличива-ется [3, 4]. В 2010 г. в Болонье рабочей группой Евро-пейского общества репродукции человека и эм-бриологии было дано определение «слабому» ответу яичников на стимуляцию и сформу-лированы критерии, позволяющие его про-гнозировать. До публикации этого консенсу-са в 2011 г. проблема недостаточного ответа яичников в программах ВРТ была очевидна, но не конкретизирована в диагностическом аспекте.Согласно Болонским критериям «слабого» ответа яичников на стимуляцию, применение этого определения правомочно при соблюде-нии двух из трех условий [5]: 1) возраст женщины 40 и более лет или нали-чие других факторов риска «слабого» ответа на стимуляцию; 2) сниженный овариальный резерв (число ан-тральных фолликулов < 5-7; антимюллеров гормон (АМГ) < 0,5-1,1 нг/мл); 3) предшествующий «слабый» ответ яичников на стимуляцию при использовании адекват-ных доз гонадотропинов (3 и менее получен-ных ооцитов или отмена протокола в связи с отсутствием ответа яичников на проводи-мую стимуляцию).

show abstract

Comparing the effect of aromatase inhibitor (letrozole) + cabergoline (Dostinex) and letrozole alone on uterine myoma regression,a randomized clinical trial

Cited by 8 publications

References 40 publications

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

The Effect of Uterine Fibroids on Infertility: A Systematic Review

Aromatase inhibitors in “poor” ovarian responders undergoing in vitro fertilization

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