Role of the aromatase inhibitor letrozole in the management of uterine leiomyomas in premenopausal women

Duhan, Nirmala; Madaan, Shikha; Sen, Jyotsna

doi:10.1016/j.ejogrb.2013.09.010

Cited by 37 publications

(30 citation statements)

References 14 publications

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“…This study confirms that the administration of triptorelin, letrozole and UPA causes a significant decrease in myoma volume [2,8,[11][12][13][14]. Patients included in group U had a lower percentage decrease in myoma volume compared with other hormonal therapies and there was no significant difference in the hysteroscopy time compared to group S. Although patients in group U had higher endometrial thickness at surgery than other groups, this was not perceived as a difficulty during the resection.…”

Section: Commentssupporting

confidence: 73%

See 1 more Smart Citation

Three-month treatment with triptorelin, letrozole and ulipristal acetate before hysteroscopic resection of uterine myomas: prospective comparative pilot study

Bizzarri

Ghirardi

Remorgida

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Commentssupporting

confidence: 73%

“…Letrozole, a selective, competitive, reversible non-steroidal aromatase inhibitor decreases the volume of myomas and the intensity of associated symptoms [7][8][9][10][11]. Ulipristal acetate (UPA), a selective progesteronereceptor modulator, decreases the volume of uterine myomas and controls uterine bleeding [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Three-month treatment with triptorelin, letrozole and ulipristal acetate before hysteroscopic resection of uterine myomas: prospective comparative pilot study

Bizzarri

Ghirardi

Remorgida

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Bunun dışında, aromataz inhibitörlerinin meme kanserinde kullanımı ile ilgili yaşanan sıkıntılar, teorik olarak leiomyom tedavisinde kullanırken de gö-rülebilir. Obez hastalarda kullanırken etkisinin azalabileceği ve uzun süreli tedavide tedaviye rezistans gelişe-bileceği düşünülmektedir (30,31).…”

Section: Aromataz İnhibitörleriunclassified

Medical Treatment of Leiomyomas

Uğurlucan¹,

Demir²,

Yaşa³

et al. 2017

İstanbul Tıp Fakültesi Dergisi

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ÖZETLeiomyomlar, reprodüktif çağda en sık görülen jinekolojik tümörlerdir. Leiomyomlar çoğu kadında bulunmakla beraber, bazı kadınlarda semptomatik hale gelmektedir. Genetik veya hormonal kökenli olabilirler. Leiomyomların üzerinde östrojen ve progesteron reseptörleri olması, onları hormona duyarlı hale getirmektedir. Leiomyomların ana tedavisi cerrahi olmakla beraber, cerrahi istemeyen veya fertilitesini korumak isteyen kadınlarda medikal tedaviler gündeme gelmektedir. Medikal tedavilerin çıkış noktası, leiomyomların hormona duyarlı olmasıdır. Medikal tedavi seçenekleri arasında gonadotropin-releasing-3 hormon analogları ve antagonistleri, aromataz inhibitörleri ve selektif progesteron reseptör modülatörleri yer almaktadır. Bu tedaviler kanama kontrolünün yanında leiomyom volümünde de küçülme sağlamaktadır. Bu derlemede bu tedavi yöntemlerine değinilecektir. Anahtar Kelimeler: Leiomyom; anormal uterin kanama; selektif progesteron reseptör modülatörleri; ulipristal asetat; anemi ABSTRACTLeiomyomas are the most common benign gynecological tumors observed during the reproductive period. Although, they are exceedingly common, not all are symptomatic. Leiomyomas are of genetic or hormonal origin and have estrogen and progesterone receptors, making them sensitive to hormones. The main treatment for leiomyomas is surgery, but in women who are not willing to undergo surgery or who want to preserve their fertility, medical treatment options may be used. The main basis of medical treatment in leiomyomas are hormones due to positive response to anti-hormonal therapies. Medical treatment options comprise gonadotropin-releasing-hormone agonists and antagonists, aromatase inhibitors, and selective progesterone receptor modulators. In addition to controlling bleeding, these treatment regimens cause a decrease in the volume of the tumor. In this review, treatment options are discussed.

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“…Anastrozole and letrozole are able to inhibit >98% of aromatase activity[40, 42], and have been shown to result in significant reduction of fibroid volume and improvement in symptoms in multiple clinical trials[43-46]. Moreover, aromatase inhibitors avoid the side effects of the severe hypoestrogenism caused by GnRH agonists, particularly hot flushes[44]. …”

Section: Medical Treatmentsmentioning

confidence: 99%

“…Importantly, aromatase inhibitors are often used off-label in the follicular phase for ovulation induction or controlled ovarian stimulation, necessitating contraception in women not desiring conception[47]. Although there have been conflicting results regarding the potential for systemic hypoestrogenism with prolonged aromatase inhibitor use[44, 48], there is concern for both increased bone loss and cardiovascular risk with long-term aromatase inhibitor use, particularly in younger patients[42]. The breast cancer literature has also brought some questions as to the utility of aromatase inhibitors, reporting both decreased effectiveness in overweight and obese women and the development of resistance over time[40, 42].…”

Section: Medical Treatmentsmentioning

confidence: 99%

Endocrinology of uterine fibroids

Moravek

Bulun

2015

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of Review Uterine fibroids are extremely common, and can cause significant morbidity, yet the exact etiology of these tumors remains elusive and there are currently no long-term treatments available. In this review we aim to provide an overview of steroid hormones, genetic abnormalities, and stem cells in the pathogenesis of uterine fibroids. Recent Findings A universal feature of fibroids is responsiveness to estrogen and progesterone, and most of the currently available therapies exploit this characteristic. Ulipristal acetate has recently shown particular promise for providing long-term relief from uterine fibroids. Additionally, fibroid stem cells were isolated and appear to be necessary for growth. The recent discovery of somatic mutations involving MED12 or HMGA2 in the majority of fibroids and the links to their pathophysiology were also significant advances. Summary The recent shift in focus from hormones to fibroid stem cells and genetic aberrations should lead not only to a deeper understanding of the specific etiology of fibroids, but also to the discovery of new therapeutic targets. Targeting the products of genetic mutations or fibroid stem cells has the potential to achieve both better control of current tumors and the prevention of new fibroids.

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Role of the aromatase inhibitor letrozole in the management of uterine leiomyomas in premenopausal women

Cited by 37 publications

References 14 publications

Three-month treatment with triptorelin, letrozole and ulipristal acetate before hysteroscopic resection of uterine myomas: prospective comparative pilot study

Three-month treatment with triptorelin, letrozole and ulipristal acetate before hysteroscopic resection of uterine myomas: prospective comparative pilot study

Medical Treatment of Leiomyomas

Endocrinology of uterine fibroids

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