Place des traitements médicaux : indication, durée, efficacité, chez la femme porteuse de fibromes utérins symptomatiques en période d’activité génitale

Koskas, Martin; Chabbert-Buffet, Nathalie; Douvier, S.; Huchon, Cyrille; Paganelli, E.; Derrien, Jean

doi:10.1016/j.jgyn.2011.09.022

Cited by 19 publications

(3 citation statements)

References 108 publications

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“…Therefore, there is no indication for medical treatment in the absence of symptoms. 11 In cases with symptomatic fibroids (pain or bleeding), the treatment has traditionally been surgical. Based on a large literature review, 4 the French recommendations for the management of patients with fibroids concluded the following: When pregnancy is desired, the hysteroscopic resection of submucosal fibroids less than 4 cm in length is recommended.…”

Section: Management Of Uterine Fibroids: Medical Treatment’s Place?mentioning

confidence: 99%

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Bourdet

Luton

Koskas

2015

IJWH

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Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA), an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s).

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Section: Management Of Uterine Fibroids: Medical Treatment’s Place?mentioning

confidence: 99%

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Bourdet

Luton

Koskas

2015

IJWH

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“…These drugs may not be able to eliminate the fibroids but may reduce their related symptoms. 5 Gonadotropin-releasing hormone (GnRH) agonists are one of the well-known drugs that used in the treatment of uterine fibroids by reducing of bleeding and recovery of hemoglobin. GnRH agonists are effective in the treatment of uterine fibroids.…”

Section: Introductionmentioning

confidence: 99%

“…Letrozole is an antiestrogen that is effective on the volume of fibroids similar to GnRH agonists. 5 One study reported the effect of Letrozole on the proliferation and apoptosis of cultured fibroids cells. The result of the study showed that Letrozole could inhibit the cell proliferation and increase apoptosis.…”

Section: Introductionmentioning

confidence: 99%

Gonadotropin-releasing Hormone Agonist Plus Aromatase Inhibitor in the Treatment of Uterine Leiomyoma in Near Menopause Patient: A Case Series Study

Moradan

2018

J Menopausal Med

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ObjectivesThere are many drugs for of symptomatic fibroids. Gonadotropin-releasing hormone (GnRH) agonists are the well known drugs. Also, aromatase inhibitors are effective. All published studies surveyed the effect of one of these two drugs. In this study as the first study decided to evaluate the effectiveness of the combination of GnRH agonists + aromatise inhibitor on the uterine fibroids.MethodsA cross-sectional prospective case series study was performed on 10 known cases of uterine fibroids late perimenopause, at least 3 myomas >5 cm, abnormal uterine bleeding and anemia due to fibroids, candidate for hysterectomy, no tendency to surgery. A single dose of Diphereline 11.25 mg, SR plus 2.5 mg of Letrozole daily for 4 weeks with add-back therapy + calcium carbonate were used. The second dose of Diphereline 11.25 mg, SR was used 3 months after the first injection. The patients were followed until 3 years.ResultsThe mean age of the study group was 49.90 ± 1.66. The mean fibroid size reduced from 15.05 ± 57.20 cm to 13.56 ± 39.39 cm (P = 0.012) and fibroid volume reduced from 72.78 ± 110.6 to 50.96 ± 64.2 (P = 0.116). There was no signification changes in the serum level of hormones at the end of six months. Eight cases were menopause at the end of the study and hypoestrogenism symptoms did not happened in none of the cases until the end of 24 months. Except in one case, there was no need to do surgery on others.ConclusionsCombination of Diphereline + Letrozole probably could prevent surgery in cases that have multiple fibroids, perimenopause, anemic and candidate for surgery.

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Update of Conservative Systemic Treatment of Uterine Fibroids

Zalewski

Neulen

2014

Curr Obstet Gynecol Rep

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Place des traitements médicaux : indication, durée, efficacité, chez la femme porteuse de fibromes utérins symptomatiques en période d’activité génitale

Cited by 19 publications

References 108 publications

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

Gonadotropin-releasing Hormone Agonist Plus Aromatase Inhibitor in the Treatment of Uterine Leiomyoma in Near Menopause Patient: A Case Series Study

Update of Conservative Systemic Treatment of Uterine Fibroids

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