Efficacy and safety of repeated use of ulipristal acetate in uterine fibroids

Capsule:
In a prospective randomized study, repeated 12-week courses of oral ulipristal acetate effectively control bleeding and pain, reduce fibroid volume, and restore quality of life in patients with symptomatic fibroids.

Authors:
Jacques Donnez, M.D., Robert Hudecek, M.D., Olivier Donnez, M.D., Dace Matule, M.D., Hans-Joachim Arhendt, M.D., Janos Zatik, M.D., Zaneta Kasilovskiene, M.D., Mihai Cristian Dumitrascu, M.D., Hervé Fernandez, M.D., David H. Barlow, F.R.C.O.G., Philippe Bouchard, M.D., Bart C.J.M. Fauser, M.D., Elke Bestel, M.D., Paul Terrill, Ph.D., Ian Osterloh, M.R.C.P., Ernest Loumaye, M.D.

Volume 103, Issue 2, Pages 519-527

Abstract:

Objective:
To investigate the efficacy and safety of repeated 12-week courses of 5 or 10 mg daily of ulipristal acetate for intermittent treatment of symptomatic uterine fibroids.

Design:
Double-blind, randomized administration of two 12-week courses of ulipristal acetate.

Setting:
Gynecology centers.

Patient(s):
A total of 451 patients with symptomatic uterine fibroid(s) and heavy bleeding.

Intervention(s):
Two repeated 12-week treatment courses of daily 5 or 10 mg of ulipristal acetate.

Main Outcome Measure(s):
Amenorrhea, controlled bleeding, fibroid volume, quality of life (QoL), pain.

Result(s):
In the 5- and 10-mg treatment groups (62% and 73% of patients, respectively) achieved amenorrhea during both treatment courses. Proportions of patients achieving controlled bleeding during two treatment courses were >80%. Menstruation resumed after each treatment course and was diminished compared with baseline. After the second treatment course, median reductions from baseline in fibroid volume were 54% and 58% for the patients receiving 5 and 10 mg of ulipristal acetate, respectively. Pain and QoL improved in both groups. Ulipristal acetate was well tolerated with less than 5% of patients discontinuing treatment due to adverse events.

Conclusion(s):
Repeated 12-week courses of daily oral ulipristal acetate (5 and 10 mg) effectively control bleeding and pain, reduce fibroid volume, and restore QoL in patients with symptomatic fibroids.

Clinical Trial Registration Number:
NCT01629563 (PEARL IV).

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