REVIEWS  THE DESTINY OF MYOMAS 

Minerva Ginecologica 2016 June;68(3):313-20

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

The place of selective progesterone receptor modulators in myoma therapy

Jacques DONNEZ ¹, Olivier DONNEZ ^{2, 3}, Guillaume E. COURTOY ³, Marie M. DOLMANS ^{3, 4} ✉

¹ Society for Research into Infertility (SRI, Société de Recherche pour l‘Infertilité), Brussels, Belgium; ² Institut du Sein et de Chirurgie Gynécologique d’Avignon (ICA), Polyclinique Urbain V (Groupe Vedici-Vitalia), Avignon, France; ³ Unit of Gynecology Research, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium; ⁴ Department of Gynecology, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Uterine fibroids are the most commonly encountered benign uterine tumors in women of reproductive age. As progesterone is known to play a key role in promoting myoma growth, the goal of the study was to analyze the efficacy of selective progesterone receptor modulators (SPRMs). From four studies, it was concluded that UPA (ulipristal acetate) treatment was able to control myoma-associated uterine bleeding in over 90% of cases and significantly reduce myoma volume in more than 80% of women. The results of long-term intermittent therapy (PEARL III and PEARL IV studies) (4 courses of 3 months) demonstrated that more than one course of UPA is able to maximize its potential benefits in terms of control of bleeding and fibroid volume reduction. The treatment was considered safe, even at the level of endometrial changes. With the advent of SPRMs, new algorithms should be discussed, as there is no doubt that there is a place for medical therapy with SPRMs in the current armamentarium of fibroid management.