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KMID : 0358420170600010069
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Korean Journal of Obstetrics and Gynecology
2017 Volume.60 No. 1 p.69 ~ p.73
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Uterine fibroid shrinkage after short-term use of selective progesterone receptor modulator or gonadotropin-releasing hormone agonist
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Lee Min-Jin
Yun Bo-Seong
Seong Seok-Ju
Kim Mi-La
Jung Yong-Wook
Kim Mi-Kyoung
Bae Hyo-Sook
Kim Da-Hee
Hwang Ji-Young
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Abstract
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Objective: The aim of this study was to evaluate the effect of short-term use of selective progesterone receptor modulator (SPRM) or gonadotropin-releasing hormone (GnRH) agonist on uterine fibroid shrinkage among Korean women.
Methods: This retrospective study involved 101 women with symptomatic uterine fibroids who received ulipristal acetate (SPRM, n=51) and leuprolide acetate (GnRH agonist, n=50) for 3 months between November 2013 and February 2015. The fibroid volume was measured both before and after treatment using ultrasonography, computed tomography, and magnetic resonance imaging. The outcomes were compared between the SPRM and GnRH agonist groups.
Results: The median rate of fibroid volume reduction after SPRM treatment was 12.4% (IQR ?14.5% to 40.5%) which was significantly lower than the reduction rate observed after GnRH agonist treatment (median 34.9%, IQR 14.7% to 48.6%, P=0.004). 19 of 51 (37.3%) patients with SPRM treatment did not show any response of volume shrinkage, while 7 of 50 (14.0%) women with GnRH agonist showed no response (P=0.007).
Conclusion: Short-term SPRM treatment yields lower volume reduction than GnRH agonist treatment in Korean women with symptomatic fibroids. Further large-scale randomized trials are needed to confirm our findings.
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KEYWORD
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Gonadotropin-releasing hormone agonist, Leiomyoma, Selective progesterone receptor modulator, Volume reduction
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