Successful treatment of a symptomatic uterine leiomyoma in a perimenopausal woman with a nonsteroidal aromatase inhibitor

Shozu, Makio; Murakami, Kazuhiko; Segawa, Tomoya; Kasai, Tokuzo; Inoue, Masakí

doi:10.1016/s0015-0282(02)04761-1

Cited by 75 publications

(53 citation statements)

References 32 publications

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“…Because of this, it is almost conclusively used only preoperatively. Second, administering aromatase inhibitors lowers local estrogen levels by suppressing conversion of androgens to estrogen (40). Similar to GnRHa, aromatase inhibitors are associated with significant estrogen-deprivation side effects.…”

Section: Steroid Signaling Estrogenmentioning

confidence: 99%

Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

Borahay

Al-Hendy

Kılıç

et al. 2015

Mol Med

128

147

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Uterine leiomyomas are the most common tumors of the female genital tract, affecting 50% to 70% of females by the age of 50. Despite their prevalence and enormous medical and economic impact, no effective medical treatment is currently available. This is, in part, due to the poor understanding of their underlying pathobiology. Although they are thought to start as a clonal proliferation of a single myometrial smooth muscle cell, these early cytogenetic alterations are considered insufficient for tumor development and additional complex signaling pathway alterations are crucial. These include steroids, growth factors, transforming growth factor-beta (TGF-β)/Smad; wingless-type (Wnt)/β-catenin, retinoic acid, vitamin D, and peroxisome proliferator-activated receptor γ (PPARγ). An important finding is that several of these pathways converge in a summative way. For example, mitogen-activated protein kinase (MAPK) and Akt pathways seem to act as signal integrators, incorporating input from several signaling pathways, including growth factors, estrogen and vitamin D. This underlines the multifactorial origin and complex nature of these tumors. In this review, we aim to dissect these pathways and discuss their interconnections, aberrations and role in leiomyoma pathobiology. We also aim to identify potential targets for development of novel therapeutics.

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Section: Steroid Signaling Estrogenmentioning

confidence: 99%

Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

Borahay

Al-Hendy

Kılıç

et al. 2015

Mol Med

128

147

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“…16 Apart from this, many other studies have reported on the use of various aromatase inhibitors in this condition with variable results.…”

Section: Discussionmentioning

confidence: 99%

Effects of letrozole on patients with symptomatic leiomyoma in the reproductive age women

Prakash

Pandey

Chawla

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Uterine leiomyoma is a common indication for hysterectomy in India. An effective medical treatment option may reduce hysterectomy associated morbidity. This study was undertaken to evaluate the effect of the Letrozole on patients with symptomatic leiomyoma in the reproductive age women.Methods: Prospective interventional study was conducted on 50 women between 30-45 years of age with menstrual or pressure symptoms on the bowel or urinary system, and having no. Of myoma ≤4 and size of single myoma ≥2 cms in diameter. They received tablet letrozole 5mg/day for 3 month, and effect of the drug on myoma volume and symptomatology were studied. Beside these, effects on uterine volume, ovarian volume, endometrial thickness and side effects of letrozole of any were also studied.Results: Average reduction of myoma volume by 47.68% and uterine volume by 19.58% was seen. Haemoglobin concentration was significantly higher at the end of study. It increased from 9.56g/dl to 10.76g/dl and overall improvement in symptomatology score was observed. Ovarian volume increased significantly from baseline mean volume of 8.18±0.51cm³ to 19.3±0.84cm³ and no significant change in endometrial thickness was observed at the end of 3 month. Sweating, hot flushes, nausea and vomiting were the main adverse effects observed and were self limiting.Conclusions: Letrozole, the aromatase inhibitor resulted in significant volume reduction of the uterus-leiomyoma structure and was effective in controlling the more frequent symptoms of this disorder with fewer side effects.

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“…Both fadrozole [36,37] and anastrozole [38, 39•] have been shown to reduce myoma volume effectively. These substances are associated with rapid onset of action, and the initial flare-up effect of GnRH agonists is absent.…”

Section: Aromatase Inhibitorsmentioning

confidence: 99%

“…These substances are associated with rapid onset of action, and the initial flare-up effect of GnRH agonists is absent. Shozu reported 71% reduction in myoma volume after 8 weeks of treatment with fadrozole [36], and no significant change in estradiol level was reported [37, 39•].…”

Section: Aromatase Inhibitorsmentioning

confidence: 99%

Medical Management of Uterine Fibroids

Parsanezhad

Jahromi

2012

Curr Obstet Gynecol Rep

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Uterine leiomyomas are the most common benign tumors of the uterus. Though benign, they can affect the quality of life for many women. Compared with the standard surgical treatments, medical therapy is attractive and avoids possible surgery-related complications. No medical therapy currently exists that can induce rapid regression of the myoma and symptoms with minimal side effects without affecting fertility. This review evaluates medical treatments that are currently available for the treatment of uterine fibroids.

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Successful treatment of a symptomatic uterine leiomyoma in a perimenopausal woman with a nonsteroidal aromatase inhibitor

Cited by 75 publications

References 32 publications

Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

Effects of letrozole on patients with symptomatic leiomyoma in the reproductive age women

Medical Management of Uterine Fibroids

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