Mifepristone myoma

The PA mifepristone also delays or inhibits ovulation, which may produce amenorrhea [48, 49]. Amenorrhea may be a consequence of an effect at the level of the ovary, pituitary or hypothalamus. The SPRM asoprisnil, in contrast, is not so effective in inhibiting ovulation [50]. The amenorrhea consequent to PAs and SPRMs occurs with levels of estradiol in the range of the early follicular phase of the menstrual cycle [48-50]. As a result ofthe antiproliferative effect and the amenorrhea, PAs and SPRMs have been advocated in the treatment of uterine myoma, endometriosis and dysfunctional uterine bleeding. 

A review of six clinical trials involving 166 women treated with mifepristone administered in doses of 5-50 mg/day for 3-6 months resulted in reductions in myoma volumes of 26-74%, with rates of amenorrhea of 63-100%. The prevalence and severity of dysmenorrhea, menorrhagia and pelvic pressure was reduced [69]. 

In one of these studies, treatment was extended for up to 1 year in 40 premenopausal women with large symptomatic myoma who received mifepristone in doses of5orl0mg daily [70,71].Mean uterine volumes decreased by 48% in both groups by 6 months and to 53% at 1 year. None of the above trials conducted with mifepristone was placebo-controlled. 

Recently, a randomized double-blind placebo-controlled 26-week study was performed in 42 women with symptomatic myoma. Women randomized to mifepristone... 

Eisinger, S.H., Bonfiglio, T., Fiscella, K., Meldrum, S. and Guzick, D.S. (2005) Twelve-month safety and efficacy of low-dose mifepristone for uterine myomas. Journal of Minimally Invasive Gynecology, 12, 227-233. 

Esteve JL, Acosta R, Perez Y, Rodriguez B, Seigler 1, Sanchez C, et al. Mifepristone versus placebo to treat uterine myoma a double-blind, randomized clinical trial. Int J Womens Health 2013 5 361-9. 

Carbonell JL, Acosta R, Perez Y, Garces R, Sanchez C, Tomasi G. Treatment of uterine myoma with 2.5 or 5 mg mifepristone daily during 3 months with 9 months posttreatment followup randomized clinical trial. ISRN Obstet Gynecol 2013 2013. 649030. 

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