Intermittent leuprolide acetate for the nonsurgical management of women with leiomyomata uteri.
OBJECTIVE
To evaluate the feasibility of intermittent 6-month courses of leuprolide acetate for the long-term control of symptoms attributed to leiomyomata uteri.


METHODS
Prospective open-label feasibility study.


METHODS
University department of obstetrics and gynecology.


METHODS
Thirty women with abnormal bleeding or discomfort (pain or pressure) due to leiomyomata uteri.


METHODS
Patients received an initial 6-month course of the GnRH agonist leuprolide acetate, after which they were observed for symptom recurrence. Symptom recurrence was managed by repeated 6-month courses of leuprolide acetate.


METHODS
Relief of symptoms, responses on a quality-of-life questionnaire, serum lipid levels, blood count, and ferritin level. The number of doses of leuprolide acetate required to maintain symptom control was recorded. Serial bone mineral density measurements were made in selected patients.


RESULTS
Twenty of the 30 women who began therapy with leuprolide acetate continued in the protocol. Each individual 6-month course of leuprolide acetate therapy was followed by a median of 9 additional months of symptom control (range, 2 to >25 months). Women remaining in the protocol experienced a mean decrease of 2.4% in bone mineral density of the lumbar spine; bone mineral density of the hip did not change.


CONCLUSIONS
Intermittent courses of leuprolide acetate can be used in the nonsurgical management of women with symptomatic leiomyomata uteri. Use of antiresorptive add-back therapy and monitoring of bone mineral density can be considered when repeated courses of leuprolide acetate are given.
Scialli
A R
AR
Georgetown University Medical Center, Washington, D.C. 20007-2197, USA. sciallia@gunet.georgetown.edu
Levi
A J
AJ
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D015519:Bone Density; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy*; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014594:Uterine Neoplasms / Q000188:drug therapy*
D018931:Antineoplastic Agents, Hormonal; D016729:Leuprolide