Abstract
EFFICACY OF USE OF LONG-TERM, LOW-DOSE ULIPRISTAL ACETATE FOR THE TREATMENT OF FIBROIDS

*Sandhyarani Guggilla, Iran Gangarapu, Ammavenu and Sarangapani M. 

ABSTRACT

Introduction: Uterine fibroids, also called fibroid tumors, fibromyomas, myofibroma, leiomyofibroma, fibroleiomyoma, myoma, fibroma and leiomyoma, are benign tumors that develop in uterus. This is the most common tumor of the uterus and female pelvis.[1] The incidence is generally cited as 20–25 percent, but has been shown to be as high as 70–80 percent in studies using histologic and sonographic examinations. Majority of fibroids are asymptomatic; however, when symptomatic, patients present with menstrual disturbances, infertility, lump abdomen or pressure effects.[2] Management of fibroids can be surgical or medical. Among the surgical options, hysterectomy is viewed as the definitive management of symptomatic uterine fibroids. Myomectomy is an alternative for patients who desire childbearing, young patients, and for those who prefer to retain the uterus. Medical management may be given to minimize symptoms and signs, and for patients where surgery is contraindicated. Drugs available are antifibrinolytic-tranexamic acid, danazol, GnRH analogs, progestogens and the antiprogesterone Ulipristal Acetate. Ulipristal Acetate, an antiprogesterone was approved by FDA on September 28, 2000, with the trade name ‗Mifegyne‘ as an abortifacient. The immune reactivity of progesterone receptors in the myoma and myometrial tissue was decreased significantly by this drug, suggesting the regression of these tumors may be obtained through a direct antiprogesterone effect. Varying dosage regimens have been suggested for treatment of fibroids though consensus is for a dose between 5 to 10 mg daily. Higher doses have not shown any increase in the beneficial effect while the side effects have been found to increase.[3] We studied the effect of Ulipristal Acetate given once a week on uterine fibroids for 6 months. The available literature predominantly has studied effects of 3 months exposure with this drug, but in this study, we decided to study the effects of this drug when used for 6 months.

Keywords: Uterine fibroids, also direct antiprogesterone effect.


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