The Conservative and Interventional Treatment of Fibroids

Boosz, Alexander; Reimer, Peter; Matzko, M; Römer, Thomas; Müller, Andreas

doi:10.3238/arztebl.2014.0877

Cited by 28 publications

(29 citation statements)

References 71 publications

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“…Uterine fibroids are the most common neoplasm affecting women, and it has been postulated that they occur in over 70% of women by the onset of menopause . They are estimated to be clinically apparent in 25% of women of reproductive age and cause symptoms severe enough in approximately 25% of women with UFs to require treatment .…”

Section: Introductionmentioning

confidence: 99%

“…[19][20][21][22][23][24] Uterine fibroids are the most common neoplasm affecting women, and it has been postulated that they occur in over 70% of women by the onset of menopause. [25][26][27] They are estimated to be clinically apparent in 25% of women of reproductive age and cause symptoms severe enough in approximately 25% of women with UFs to require treatment. 4,28,29 The frequency of the condition is, however, likely to be underestimated because in many women it is asymptomatic, or symptoms develop insidiously, and…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of uterine fibroids: a systematic review

Stewart

Cookson

Gandolfo

et al. 2017

BJOG

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Background Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility.Objectives To examine UF epidemiology and to evaluate the relative strengths of putative risk factors.Search strategy MEDLINE and Embase were searched for studies published in English between January 1995 and April 2015.Selection criteria Publications reporting relevant data from registries and other observational studies with over 1000 patients and single-centre studies with over 100 patients were selected.Data collection and analysis Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications.Main results Wide ranges were reported in both UF incidence (217-3745 cases per 100 000 women-years) and prevalence (4.5-68.6%), depending on study populations and diagnostic methods. Black race was the only factor that was recurrently reported to increase UF risk, by two-threefold compared with white race. Eleven other factors affected UF risk to a magnitude similar to or greater than race. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk.Conclusions We identified 12 risk factors that play an important role in UF epidemiology. The UF risk factor with the strongest evidence is black race. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management.Keywords Epidemiology, incidence, leiomyoma, prevalence, race, risk factors, uterine fibroids.Tweetable abstract Uterine fibroids occur in about 70% of women. Black race and 11 other factors affect uterine fibroid risk.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epidemiology of uterine fibroids: a systematic review

Stewart

Cookson

Gandolfo

et al. 2017

BJOG

728

526

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“…It has been studied that over 70% of the female by the time of onset of their menopause may present with uterine fibroid. [2][3][4] The commonest risk factor for development of fibroid is the age of patient. It has been seen that this tumor is ten times more common in women in their fifth and sixth decade of life as compared to those in their third decade.…”

Section: Benign Tumorsmentioning

confidence: 99%

Histopathological spectrum of neoplastic lesions of female reproductive system-a two-year experience in Eastern Nepal

et al. 2018

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Background: Neoplastic lesions of female reproductive system (FRS) consist majority of surgical cases. The aim of this study is to find out the frequency distribution of tumors occurring in FRS.Methods: This is a retrospective study carried out in Birat Medical College, situated in eastern Nepal. All formalin fixed surgical specimen of FRS from August 2015 to September 2017 were subjected for histopathology and examined under light microscopy. All neoplastic lesions were included, and non-neoplastic lesions were excluded from the study.Results: A total number of ninety (90) histopathological tissues representating various types of neoplastic lesion of FRS were studied. Out of which 6 (6.6%) tumors were from uterine cervix, (including 1 cervical leiomyoma and 5 squamous cell carcinoma cervix) 45(50%) tumors were from uterine body, (all leiomyoma) 20 (22.2%) tumors were from ovary (including 9 mature teratoma, 1 immature teratoma, 6 mucinous cystadenoma and 4 cases of serous cystadenoma) and 19 (21.2%) tumors were from breast (including 16 fibroadenoma, 1 lactational adenoma, 2 infiltrating ductal carcinoma and 1 comedo carcinoma). Majority 81(90%) were benign and 9 (10%) were malignant. Most common benign tumor was leiomyoma of uterine body and most common malignant tumor was squamous cell carcinoma of uterine cervix both commonly occurring in the age group of 41-50 years.Conclusions: Benign tumor, leiomyoma is the common tumor occurring in FRS. Carcinoma of the cervix is the common malignant tumor.

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“…Uterine-sparing surgical interventions exist, but they are associated with frequent symptom recurrence and need for reintervention (1,16,17). Currently available medical options are limited, and some treatment options are associated with significant adverse events, such as reduction in bone mineral density and hot flushes (18)(19)(20)(21).…”

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confidence: 99%

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

Bradley

Singh

Simon

et al. 2019

Fertility and Sterility

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Objectives: To assess the safety and efficacy of four vilaprisan doses (0.5-4.0 mg) in women with uterine fibroids. Design: Randomized, double-blind, placebo-controlled, multicenter trial. Setting: Ninety-eight centers in 12 countries. Patient(s): Women aged 18-50 years with uterine fibroids and heavy menstrual bleeding were randomized equally to oral vilaprisan at 0.5, 1.0, 2.0, or 4.0 mg or placebo once daily. Intervention(s): Treatment for 12 weeks, 24-week follow-up. Main Outcome Measure(s): Primary end point was absence of scheduled or unscheduled bleeding/spotting. Key secondary efficacy end points included volume of menstrual blood loss and change in fibroid volume. Result(s): A total of 309 patients were randomized, and 300 received treatment. Complete absence of bleeding/spotting was observed in 30%, 56%, 54%, and 60% of patients in the vilaprisan 0.5, 1.0, 2.0, and 4.0 mg groups, respectively, versus 1.7% with placebo. After 12 weeks, >83% of women achieved amenorrhea (<2 mL/28 days) with R1.0 mg vilaprisan versus 9% with placebo. Heavy menstrual bleeding stopped (but returned at a lower volume after treatment cessation) with R1.0 mg vilaprisan treatment. Reductions in fibroid volume of up to 41% were observed. Most patients receiving vilaprisan reported improvements in symptom severity. No safety concerns were identified in general safety, endometrial safety (by biopsy), laboratory values, and ultrasound examinations. Conclusion(s): ASTEROID 1 supports the efficacy of vilaprisan for the treatment of heavy menstrual bleeding associated with uterine fibroids. Daily oral treatment with vilaprisan 0.5-4.0 mg was well tolerated, and vilaprisan 2.0 mg once daily has been selected for further investigation.

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The Conservative and Interventional Treatment of Fibroids

Abstract: Multiple treatment options are available and enable individualized therapy for symptomatic fibroids. The most important considerations in the choice of treatment are the question of family planning and, in some cases, the technical limitations of the treatments themselves.

Cited by 28 publications

References 71 publications

Epidemiology of uterine fibroids: a systematic review

Epidemiology of uterine fibroids: a systematic review

Histopathological spectrum of neoplastic lesions of female reproductive system-a two-year experience in Eastern Nepal

Vilaprisan in women with uterine fibroids: the randomized phase 2b ASTEROID 1 study

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