Comparison between Mifepristone and Ulipristal acetate as an alternative to surgical management of uterine fibroids (Leiomyoma) in symptomatic patients of reproductive age group in Asian population

Abstract

Background: Present study was a randomised prospective observational study carried out at Ashakiran Hospital and IVF centre Pune, Maharashtra, India to evaluate the efficacy, safety, and quality of life by using Ulipristal acetate 10 mg and Mifepristone 25 mg daily doses to treat uterine fibroids of two subgroups involving fibroids <3 cm and fibroids 3 to 5 cm all are in reproductive age group with symptomatic in nature over 3 months. Methods: A total number of 40 patients were recruited in the study of which they were divided into two groups according to the size of the fibroid as <3cm and 3-5cm as seen on transvaginal as well as transabdominal ultrasound. Further they were randomly assigned to either mifepristone or ulipristal orally with each category having 10 patients each to assess changes in fibroid size, in symptomatic pain reduction, menorrhagia and in quality of life. Results: The 25-mg dosage of Mifepristone is shown to be a good and effective way of treatment in fibroids less than 3 cm in achieving 40% reduction in size and 50% reduction in menorrhagia as compared to Ulipristal 10 mg which acts better in other subgroup of size 3-5 cm of fibroids. Conclusions: Still larger RCTs are needed to study the long-term benefits of these drugs.

Role of selective progesterone receptor modulators in the treatment of symptomatic uterine fibroids

“…Kale AR in his study found ulipristal acetate and mifepristone, in women with symptomatic fibroids were associated with decreased pain. 19 It was observed that mifepristone was more effective in reducing pain than ulipristal acetate in patients having fibroid size of less than 3 cm.…”

“…Kale AR revealed that mifepristone was associated in reduction in size of fibroids by 55% and 40% in patients having fibroid size of more than 3-5 cm and less than 3 cm respectively. 19 Feng C21 in their comparative study of women with symptomatic uterine fibroids who were treated with 5 mg or 2.5 mg of mifepristone or placebo found that treatment with mifepristone was associated with significant improvement in health-related quality of life.…”

To Compare the Efficacy of Ulipristal acetate and Mifepristone in Management of Uterine Fibroids in Symptomatic Patients of Reproductive Age Group

“…Similar results were reported by study carried out by Kale AR in 2018. 15 The fall in myoma volume was higher in group A at the end of 3 months (35.23%) than group B (33.45%) and it significantly persisted in group A (34.51%) at the end of 6 months follow up than group B (27.56%), amenorrhoea developed in 91% patients in group A and 72% in group B, but at 6th month of follow up, it persisted only in 86% group A and 65 in group B. Woman's compliance and acceptance of medical management protocol is clear from the low drop out in both the groups (A: 5/50 and B: 10/50) and up to 90% post-treatment follow-up rate.…”

Мифепристон В Терапии Миомы Матки У Женщин Репродуктивного Возраста

“…Ëåéîìèîìà ìàòêè ÿâëÿåòñÿ ñàìîé ðàñïðîñòðàíåííîé îïóõîëüþ ðåïðîäóêòèâíîé ñèñòåìû. ×àñòîòà âñòðå÷àåìîñòè ìèîìû ìàòêè ñðåäè ãèíåêîëîãè÷åñêèõ çàáîëåâàíèé ñîñòàâëÿåò îò 25 äî 50 %, à ó aeåíùèí ðåïðîäóêòèâíîãî âîçðàñòà -îêîëî 30 % [4,6], ÷òî íåðåäêî ìîaeåò ñòàòü ïðè÷èíîé áåñïëîäèÿ, îäíèì èç ïà-òîãåíåòè÷åñêèõ ôàêòîðîâ ðàçâèòèÿ êîòîðîãî ïðè äàííîé íîçîëîãèè ñ÷èòàþò óâåëè÷åíèå è äåôîðìàöèþ ïîëîñòè ìàòêè, ñîïðîâîaeäàþùèåñÿ íàðóøåíèåì ñîêðàòèòåëüíîé àêòèâíîñòè ìèîìåòðèÿ [7]. Ïðè ýòîì àáñîëþòíîå ÷èñëî aeåíùèí, èìåþùèõ áåðåìåííîñòü ïðè ìèîìå ìàòêè, ïîñòîÿííî âîçðàñòàåò, à íàñòóïëåíèå åå âûíóaeäàåò îïðåäåëÿòü òàêèõ ïàöèåíòîê â ãðóïïó âûñîêîãî ðèñêà ïî âîçíèêíîâåíèþ ðàçíîãî ðîäà îñëîaeíåíèé, óãðîaeàþùèõ çäîðîâüþ êàê ïëîäà, òàê è ìàòåðè [2,8].…”