A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status.
OBJECTIVE
To examine and compare the efficacy and safety of GnRH agonist (GnRHa) vs. aromatase inhibitor in premenopausal women with leiomyomas.


METHODS
Multicenter, randomized, controlled clinical trial.


METHODS
University hospitals.


METHODS
A total of 70 subjects with a single uterine myoma measuring >or=5 cm. Subjects were randomized into two groups with use of a random table. They were treated with aromatase inhibitor (group A) or GnRHa (group B).


METHODS
Group A received letrozole (2.5 mg/d) for 12 weeks. Group B received triptorelin (3.75 mg/mo) for 12 weeks.


METHODS
Measurement of myoma volume and E(2), FSH, LH, and T levels.


RESULTS
Total myoma volume decreased by 45.6% in group A and 33.2% in group B. Reductions in myoma volume in the two groups were statistically significant. There was no significant change in hormonal milieu in group A. The serum level of hormones significantly decreased in group B by the 12th week of treatment.


CONCLUSIONS
Uterine myoma volume was successfully reduced by use of an aromatase inhibitor. Rapid onset of action and avoidance of initial gonadotropin flare with an aromatase inhibitor may be advantageous for short-term management of women with myomas of any size who are to be managed transiently and who wish to avoid surgical intervention, specifically women with unexplained infertility having uterine myoma.
Parsanezhad
Mohammad Ebrahim
ME
Department of Gynecology and Obstetrics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran. parsanezhad@msn.com
Azmoon
Mina
M
Alborzi
Saeed
S
Rajaeefard
Abdoreza
A
Zarei
Afsun
A
Kazerooni
Talieh
T
Frank
Vivian
V
Schmidt
Ernst Hienrich
EH
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D005858:Germany; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006728:Hormones / Q000097:blood*; D006785:Hospitals, University; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D007492:Iran; D007889:Leiomyoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000077289:Letrozole; D007986:Luteinizing Hormone / Q000097:blood; D009570:Nitriles / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D017329:Triptorelin Pamoate / Q000009:adverse effects / Q000627:therapeutic use*; D047368:Tumor Burden / Q000187:drug effects; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D043373:Follicle Stimulating Hormone, Human; D006728:Hormones; D009570:Nitriles; D014230:Triazoles; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D004958:Estradiol; D000077289:Letrozole; D007986:Luteinizing Hormone