TY - JOUR
T1 - Therapeutic drugs in the treatment of symptomatic uterine fibroids
AU - Hoellen, Friederike
AU - Griesinger, Georg
AU - Bohlmann, Michael K.
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Introduction: The therapy of symptomatic uterine fibroids is based on surgery in the majority of cases. Conservative medical treatment in cases of contraindication against operative treatment, bleeding control or preoperative down-sizing of the fibroids is classically based on sex steroid depletion by gonadotropin-releasing hormone (GnRH) agonist administration for a prolonged period. However, this approach is associated with often severe climacteric side effects and fibroids quickly relapse after treatment cessation. Furthermore, the achievement of menstrual bleeding control has been tried by administration of combined oral contraceptives, progestins or the levonorgestrel-releasing intrauterine device. These approaches, however, are not associated with a significant reduction in fibroid volume. Areas covered: With the introduction of Ulipristal acetate (UPA), a new selective progesterone receptor modulator (SPRM) is now licensed for the preoperative treatment of fibroids. The administration should be limited to 3 months. UPA induces amenorrhea within a relatively short term of-on average-7 days and may thus reduce fibroid-induced anemia. Furthermore, a significant reduction of the fibroid volume persisting after cessation of the treatment could be demonstrated for UPA. Herein, a review of the current therapeutic options for conservative and preoperative medical fibroid treatment is given and the clinical utility of UPA is outlined. Expert opinion: In contrast to precedent myoma medication, volume reduction of the fibroids persists several months after cessation of UPA-administration. UPA optimizes operative conditions and thus the postoperative outcome by reducing anemia and down-sizing of fibroids.
AB - Introduction: The therapy of symptomatic uterine fibroids is based on surgery in the majority of cases. Conservative medical treatment in cases of contraindication against operative treatment, bleeding control or preoperative down-sizing of the fibroids is classically based on sex steroid depletion by gonadotropin-releasing hormone (GnRH) agonist administration for a prolonged period. However, this approach is associated with often severe climacteric side effects and fibroids quickly relapse after treatment cessation. Furthermore, the achievement of menstrual bleeding control has been tried by administration of combined oral contraceptives, progestins or the levonorgestrel-releasing intrauterine device. These approaches, however, are not associated with a significant reduction in fibroid volume. Areas covered: With the introduction of Ulipristal acetate (UPA), a new selective progesterone receptor modulator (SPRM) is now licensed for the preoperative treatment of fibroids. The administration should be limited to 3 months. UPA induces amenorrhea within a relatively short term of-on average-7 days and may thus reduce fibroid-induced anemia. Furthermore, a significant reduction of the fibroid volume persisting after cessation of the treatment could be demonstrated for UPA. Herein, a review of the current therapeutic options for conservative and preoperative medical fibroid treatment is given and the clinical utility of UPA is outlined. Expert opinion: In contrast to precedent myoma medication, volume reduction of the fibroids persists several months after cessation of UPA-administration. UPA optimizes operative conditions and thus the postoperative outcome by reducing anemia and down-sizing of fibroids.
UR - http://www.scopus.com/inward/record.url?scp=84884576767&partnerID=8YFLogxK
U2 - 10.1517/14656566.2013.825607
DO - 10.1517/14656566.2013.825607
M3 - Scientific review articles
C2 - 23914973
AN - SCOPUS:84884576767
VL - 14
SP - 2079
EP - 2085
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
SN - 1465-6566
IS - 15
ER -