Mifepristone for uterine fibroids

Tristán, Mario; Orozco, Leonardo J; Steed, Antonia; Ramírez-Morera, Anggie; Stone, Peter

doi:10.1002/14651858.cd007687.pub2

Cited by 62 publications

(64 citation statements)

References 37 publications

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“…Modulation of collagen metabolism, in leiomyoma cells, by E has been demonstrated (55,56). Use of selective ER modulators (e.g., raloxifene and tamoxifen) (57) and selective PR modulators (e.g., asoprisnil and ulipristal acetate) (17,42,43,45,47,58) support the data that E and P play a role in collagen production. Exposure to both GnRH-a significantly decreased the COL1 protein within 24 hours, supporting the fact that both are known to clinically decrease the leiomyoma volume.…”

Section: Discussionmentioning

confidence: 72%

See 1 more Smart Citation

Gonadotropin-releasing hormone analogues inhibit leiomyoma extracellular matrix despite presence of gonadal hormones

Malik

Britten

Cox

et al. 2016

Fertility and Sterility

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This study demonstrates that GnRH-a directly affect the gonadal hormone-regulated collagen-1, fibronectin, and versican production in their presence. These findings suggest that localized therapy with GnRH-a may inhibit leiomyoma growth even in the presence of endogenous gonadal hormone exposure, thereby providing a mechanism to eliminate the hypoestrogenic side effects associated with GnRH-a therapy.

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Section: Discussionmentioning

confidence: 72%

“…This is supported by a decrease in tumor volume and symptoms with the use of gonadal hormone receptor modulators and antiprogestins in preclinical studies and clinical settings (16,17,(39)(40)(41)(42)(43)(44)(45)(46)(47). Clinical trials for selective ER modulators have not been successful.…”

Section: Discussionmentioning

confidence: 99%

Gonadotropin-releasing hormone analogues inhibit leiomyoma extracellular matrix despite presence of gonadal hormones

Malik

Britten

Cox

et al. 2016

Fertility and Sterility

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show abstract

“…It has a direct suppressive effect on endometrial vasculature and reduces stromal VEGF causing less menstrual blood loss [35][36][37][38] . Cochrane study in 2012 concluded that mifepristone reduces heavy menstrual bleeding and improved fibroid specific quality of life but does not reduce fibroid volume significantly and further studies are required for recommendation for treatment.…”

Section: Leiomyomasmentioning

confidence: 99%

Mifepristone in Obstetrics and Gynaecology

Choudhury¹

2018

OBGYN

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Mifepristone acts by antagonising the biological action of progesterone acting as competitive receptor antagonist. Medical abortion with mifepristone and prostaglandin is an effective method. Continuous administration of mifepristone in a dose of 2mg/day for 30 days inhibits ovulation and delays menstruation. It has also been used in a dose of 600 mg as post-coital contraception within 72 hours. It has marked effect on cervical dilatation and myometrial contractility and therefore justifies its future trial for use in induction of labour. It can be used for the treatment of ectopic pregnancy and endometriosis but further verification is needed by randomized controlled trials. Mifepristone reduces BCL-2, decreases EGF expression in uterine fibroid cells and increases TNF and thereby reducing fibroid size and volume. Recent cochrane study revealed that mifepristone reduces heavy menstrual bleeding and improved fibroid specific quality of life but does not reduce fibroid volume significantly and further studies are required for recommendation for treatment.

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“…Anormal endometrial histoloji riski plasebo grubuna oranla anlamlı olarak çok yüksektir. Çalışmala-rın bir tanesinde hayat kalitesinde anlamlı düzelme tespit edilmiştir (39). Yazarlar, sonuç olarak, mifepristonun aşırı kanamayı azalttığını, hayat kalitesini düzelltiğini; ancak leiomyoma volümünü etkilemediğini belirtmiştir.…”

Section: Selektif Progesteron Reseptör Modülatörleriunclassified

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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Mifepristone for uterine fibroids

Cited by 62 publications

References 37 publications

Gonadotropin-releasing hormone analogues inhibit leiomyoma extracellular matrix despite presence of gonadal hormones

Gonadotropin-releasing hormone analogues inhibit leiomyoma extracellular matrix despite presence of gonadal hormones

Mifepristone in Obstetrics and Gynaecology

Medical Treatment of Leiomyomas

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