EXPERIENCE WITH ULIPRISTAL ACETATE IN PATIENTS WITH UTERINE MYOMA

Objective. To estimate changes in the reduction in myoma nodules in patients with uterine myoma treated with ulipristal acetate (UPA). Its safety profile was additionally evaluated. Subjects and methods. The study included 91 patients aged 25-40years with elective myomectomy for multiple uterine myoma with a total volume of 250-400 cm3. All the study participants were given UPA 5 mg/day for 3 months. To evaluate changes in the reduction of the sizes of nodules, their volume size was estimated before and 3 months after termination of treatment. In multiple uterine myomas, the volume of three largest myomas was calculated. Prior to and following treatment, clinical and biochemical blood tests were carried out, the coagulation system was investigated, and mucosal aspirates of the corpus uteri were histologically evaluated. Results. After termination of 3-month therapy, the volume of nodules decreased by 27.2%; by the end of the therapy, 65 (71%) patients developed amenorrhea. The performed treatment could postpone surgery in 40% of the patients; however, this effect was unstable; and 6 months after therapy termination only 5.5% of the women did not need surgery. Safety profile evaluation revealed no statistically significant changes in the total levels of triglycerides, cholesterol, low-density lipoproteins, very low-density lipoproteins, and high-density lipoproteins, and glucose. There were no significant changes in the blood coagulation system either. Conclusion. Achievement of amenorrhea in most patients may be considered to be an important therapeutic effect for patients who have abnormal uterine bleeding in the presence of uterine myoma and need delayed surgical treatment. To estimate the possibilities of UPA administration in order to avoid surgical treatment, it is necessary to assess the long-term results after a few treatment cycles.

uterine fibroids, ulipristal acetate, amenorrhea, myomectomy, uterine bleeding