Selective Progesterone Receptor Modulator(ulipristal acetate – a new option in the pharmacological treatment of uterine fibroids in women

Szamatowicz, M; Kotarski, Jan

doi:10.17772/gp/1567

Cited by 12 publications

(10 citation statements)

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“…The mainstay of management remains the surgical approach, when indicated. 5 Further on, the results of studies conducted by Lai et al, Noor et al and Eze et al support the need for treating uterine fibroids before planned pregnancy to minimize the risk of complications described above. [6][7][8] There are convincing data that progesterone and its receptors increase the proliferation activity of the cells in uterine leiomyomata, hence treatment with anti-progestins and progesterone receptor modulators seems to be reasonable 3,5 .…”

Section: Introductionmentioning

confidence: 79%

Ulipristal acetate (UPA) for fibroids–IVF outcomes following treatment with UPA after IVF failure: series of 2 case reports

Kale

2017

Int J Reprod Contracept Obstet Gynecol

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Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Fibroids are present in 5-10% of infertile patients, and may be the sole cause of infertility in 1-2.4%. The removal of fibroids by hysteroscopy and laparoscopy has now become the standard of care depending upon the size, number and location of fibroids in an infertile woman. Off lately, there is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids due to the use of selective progesterone receptor modulators (SPRMs) such as ulipristal acetate (UPA). Here, we report a case series of 2 women, with fibroids, who were put on UPA prior to IVF. These women had at least one previous IVF failure. The pre and post UPA fibroid characteristics were compared to see the effect of the drug. IVF was done post 3 month UPA therapy. Both the women showed a drastic reduction in the fibroid size, increased distance from endometrial cavity, and successful post UPA IVF cycles. Safety of the drug has been proven in few recent trials, but the role of UPA in infertile women with fibroids, who have had previous IVF failure, has opened new horizons in this field.

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Section: Introductionmentioning

confidence: 79%

Ulipristal acetate (UPA) for fibroids–IVF outcomes following treatment with UPA after IVF failure: series of 2 case reports

Kale

2017

Int J Reprod Contracept Obstet Gynecol

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“…в последние годы уделяется пристальное внимание «прогестероновой» теории возникновения миомы матки, получены убедительные данные, что прогестерон и его рецепторы в клетках лейомиомы матки вызывают повышение пролиферативной активности [21]. Эту теорию подтверждает эффективное применение препаратов из группы антагонистов прогестерона, или антигестагенов (мифепристона), или селективных модуляторов прогестероновых рецепторов (улипристала ацетат), ингибирующих рецепторы прогестерона, которые находятся в миоматозных узлах, и обеспечивающих уменьшение узлов миомы [22][23][24][25].…”

Section: консервативная терапия миомы маткиunclassified

Possibilities of applying antigestagens in therapy

et al. 2019

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In the modern medical practice, anti-progestogen therapy is widely used where RU-486 (mifepristone) is one of its variants. However, the potential of this therapy in the treatment of various pathologies is far from exhausted. In the general medical practice, it is possible to use mifepristone (RU486 metabolite) to control hyperglycemia in patients with Cushing’s syndrome, in the treatment of endogenous hypercorticism syndrome and metastatic cancer (melanoma, breast cancer, meningioma and other localizations). In the gynecological practice, it is used for contraception and early termination of pregnancy. Of particular interest is the use of antigestagens in the therapy of uterine leiomyoma. In recent years, the conservative treatment of uterine leiomyoma, aimed at the restoration and preservation of women’s reproductive health, has become a priority task for specialists. Therapy with antigestagens, in particular mifepristone, is seen as a possible worthy alternative to invasive methods of treating uterine fibroids, in which there are still many “white spots” that need to be studied.

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“…It is important to note that as many as 27% of patients undergoing myomectomy may have recurrent fibroids within 10 years after surgery [3]. Several treatment options are now available for women with symptomatic uterine fibroids, ranging from surgical treatment such as hysterectomy and myomectomy, to minimally invasive laparoscopic techniques, uterine arteries embolization (UAE) or medical therapy [4,5]. In current clinical practice, uterus-conserving therapy is the standard of care for premenopausal patients with localized myomas.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive therapeutic use of High-Intensity Focused Ultrasound (HIFU) with 3 Tesla Magnetic Resonance Imaging in women with symptomatic uterine fibroids

Łoziński¹,

Filipowska²,

Gurynowicz

et al. 2017

Ginekol Pol

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Benign uterine fibroids are common female genital tract tumors and if symptomatic often require extensive surgery. When tumors are multiple and large or unusually located, the operative treatment may lead to significant morbidity and compromise quality of life. Recovery period after surgical treatment may be complicated by patient's medical condition and wound healing problems. Currently used other non-surgical treatment modalities usually provide only a temporal symptoms relief and may not be efficient in all affected women. In the last decade, minimally invasive treatment of uterine fibroids called Magnetic Resonance guided High-Intensity Focused Ultrasound (MRI HIFU) was introduced. This technique uses thermal ablation simultaneously with MRI imaging of the mass and tissue temperature measurements during the procedure where a focused ultrasound beam is applied externally to destroy tumors located in the human body. Successful application of MRI HIFU has been recently described in patients with various malignancies, such as breast, prostate and hepatocellular cancers as well as soft tissue and bone tumors. This technique is innovative and has been proven to be safe and effective but there are several limitations for treatment. The article highlights the relative advantages and disadvantages of MRI guided HIFU in women with uterine fibroids. The authors also describe high-resolution MRI technique on 3T MRI, along with the approach to interpretation of HIFU results applied to uterine fibroids that has been experienced at one institution.

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Selective Progesterone Receptor Modulator(ulipristal acetate – a new option in the pharmacological treatment of uterine fibroids in women

Cited by 12 publications

References 0 publications

Ulipristal acetate (UPA) for fibroids–IVF outcomes following treatment with UPA after IVF failure: series of 2 case reports

Ulipristal acetate (UPA) for fibroids–IVF outcomes following treatment with UPA after IVF failure: series of 2 case reports

Possibilities of applying antigestagens in therapy

Non-invasive therapeutic use of High-Intensity Focused Ultrasound (HIFU) with 3 Tesla Magnetic Resonance Imaging in women with symptomatic uterine fibroids

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