The influence of mifepristone to caspase 3 expression in adenomyosis

Wang, Y; Jiang, Xingwei; Wang, S

doi:10.12891/ceog15872014

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…SPRMs have been shown to reduce pain, decrease menstrual flow, inhibit cell proliferation, and suppress inflammation [ 73 ]. However, there is limited evidence regarding their use specifically in women with adenomyosis, as most studies have primarily focused on their effects on endometriosis or uterine leiomyomas [ 77 ].…”

Section: The Role Of Medical Therapy For Treating Symptoms Related To...mentioning

confidence: 99%

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Etrusco,

Barra,

Chiantera

et al. 2023

Drugs

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Adenomyosis, characterized by the growth of endometrial tissue within the uterine wall, poses significant challenges in treatment. The literature primarily focuses on managing abnormal uterine bleeding (AUB) and dysmenorrhea, the main symptoms of adenomyosis. Nonsteroidal anti-inflammatory drugs (NSAIDs) and tranexamic acid provide limited support for mild symptoms or symptom re-exacerbation during hormone therapy. The levonorgestrel-releasing intrauterine system (LNG-IUS) is commonly employed in adenomyosis management, showing promise in symptom improvement and reducing uterine size, despite the lack of standardized guidelines. Dienogest (DNG) also exhibits potential benefits, but limited evidence hinders treatment recommendations. Danazol, while effective, is limited by androgenic side effects. Combined oral contraceptives (COCs) may be less effective than progestins but can be considered for contraception in young patients. Gonadotropin-releasing hormone (GnRH) agonists effectively manage symptoms but induce menopausal symptoms with prolonged use. GnRH antagonists are a recent option requiring further investigation. Aromatase inhibitors (AIs) show promise in alleviating AUB and pelvic pain, but their safety necessitates exploration and limited use within trials for refractory patients. This review highlights the complexity of diagnosing adenomyosis, its coexistence with endometriosis and uterine leiomyomas, and its impact on fertility and quality of life, complicating treatment decisions. It emphasizes the need for research on guidelines for medical management, fertility outcomes, long-term effects of therapies, and exploration of new investigational targets. Future research should optimize therapeutic strategies, expand our understanding of adenomyosis and its management, and establish evidence-based guidelines to improve patient outcomes and quality of life.

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Section: The Role Of Medical Therapy For Treating Symptoms Related To...mentioning

confidence: 99%

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Etrusco,

Barra,

Chiantera

et al. 2023

Drugs

View full text Add to dashboard Cite

show abstract

“…The current evidence concerning endometriosis and adenomyosis is leaning towards them being epigenetic diseases with aberrant methylation [65,[97][98][99]. Considering these findings, both diseases could be addressed by using demethylating agents and histone deacetylase inhibitors (HDACIs), such as valproic acid [100][101][102].…”

Section: Valproic Acidmentioning

confidence: 99%

The Present and the Future of Medical Therapies for Adenomyosis: A Narrative Review

Moawad,

Youssef,

Fruscalzo

et al. 2023

JCM

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Uterine Adenomyosis is a benign condition characterized by the presence of endometrium-like epithelial and stromal tissue in the myometrium. Several medical treatments have been proposed, but still, no guidelines directing the management of adenomyosis are available. While a hysterectomy is typically regarded as the definitive treatment for adenomyosis, the scarcity of high-quality data leaves patients desiring fertility with limited conservative options. Based on the available data, the levonorgestrel-IUD appears to offer the most favorable outcomes. Other treatments, including GnRH antagonists, dienogest, prolactin, and oxytocin modulators, show promise; however, further data are required to establish their efficacy definitively. Furthermore, there are many emerging therapies that have been developed that seem worthy of consideration in the near future. The aim of this narrative review was to explore the current medical treatments available for adenomyosis and to provide a glimpse of future therapies under assessment. For this scope, we performed a literature search on PubMed and Medline from incept to September 2022 using the keywords: “medical treatment”, “non-steroidal anti-inflammatory”, “progesterone intrauterine device”, “dienogest”, “combined oral contraceptives”, “gonadotropin releasing hormone agonist”, “gonadotropin releasing hormone antagonist”, “danazol”, “aromatase inhibitors”, “ulipristal acetate”, “anti-platelet therapy”, “dopamine”, “oxytocin antagonists”, “STAT3”, “KRAS”, “MAPK”, “micro-RNA”, “mifepristone”, “valproic acid”, “levo-tetrahydropalamatine”, and “andrographolide”. The search was limited to articles in English, with subsequent screening of abstracts. Abstracts were screened to select relevant studies.

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“…It restricts the migration of endometrial and stromal cells in adenomyosis. Therefore mifepristone can effectively inhibit the emergence and development of adenomyosis, decrease the uterine volume and cancer antigen-125 (CA-125) concentration, and increases the hemoglobin concentration in serum for adenomyosis patients [58,59]. In an interventional study of 20 adenomyosis patients on mifepristone 5 mg/day, there was significant relief concerning dysmenorrhea.…”

Section: Adenomyosismentioning

confidence: 99%

Clinical Utility of Mifepristone: Apprising the Expanding Horizons

Karena¹,

Shah²,

Vaghela³

et al. 2022

Cureus

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Mifepristone is a progesterone and glucocorticoid receptor antagonist. Medical abortion with mifepristone and prostaglandin has revolutionized the abortion process extending abortion care to the doors of females. From as low as 2 mg/day to doses extending to 600 mg, from daily dosing to single dosage treatment, mifepristone has a wide perspective in the treatment of various pathologies. Cervical dilatation and myometrial contractility have made the utility of mifepristone feasible for second-trimester termination of pregnancy and induction of labor awaiting Food and Drug Administration approvals. Its anti-progesterone action on the menstrual cycle has a new dimension of use as a contraceptive, as well as use as a menstruation inductive agent. Its role in endometriosis, ectopic pregnancy, and adenomyosis requires more intensive research. Apoptotic action of mifepristone, interference of heterotypic cell adhesion to the basement membrane, cell migration, growth inhibition of various cancer cell lines, decreased epidermal growth factor expression, suppression of invasive and metastatic cancer potential, increase in tumor necrosis factor, downregulation of cyclin-dependent kinase 2, B-cell lymphoma 2, and Nuclear factor kappa B have opened its potential to be explored as anti-cancer treatment and its effects on leiomyoma. The drug needs to be studied more for the prospectus of its anti-glucocorticoid actions in a wider dimension beyond its acquiescence for the treatment of Cushing syndrome.

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The influence of mifepristone to caspase 3 expression in adenomyosis

Cited by 11 publications

References 19 publications

Current Medical Therapy for Adenomyosis: From Bench to Bedside

Current Medical Therapy for Adenomyosis: From Bench to Bedside

The Present and the Future of Medical Therapies for Adenomyosis: A Narrative Review

Clinical Utility of Mifepristone: Apprising the Expanding Horizons

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