Low-dose mifepristone in treatment of uterine leiomyoma: a randomised double-blind placebo-controlled clinical trial.
OBJECTIVE
To evaluate the effect of low-dose mifepristone on leiomyoma-related symptoms, uterine and leiomyoma in women with symptomatic leiomyomata.


METHODS
In a double-blind placebo-controlled trial, 40 patients with symptomatic leiomyoma and normal endometrial histology were randomised to receive 10 mg mifepristone (group 1) or placebo (group 2) daily for three months. Leiomyoma-related symptoms, uterine, leiomyoma and largest leiomyoma volumes were assessed at baseline and every month for three months. Endometrial biopsy was repeated at the end of therapy.


RESULTS
Significant change was noticed between the two groups for mean menstrual blood loss (MBL) by first month. Menstrual blood loss declined by 94.8% in group 1 at three months and 84.2% patients attained amenorrhoea in this group. In group 1 complete relief of dysmenorrhoea occurred in significant number of women (80%) but only 33% patients got rid of pelvic pain. There was no change in these symptoms in group 1 Backache, urinary complaints and dyspareunia were not relieved in either group. Uterine, leiomyoma and largest leiomyoma volume declined by 26-32% in group 1 as compared to none in group 2, and this difference was statistically significant only by the end of the third month of therapy. Mean haemoglobin increased from 9.5 to 11.2 g/dL in group 1. In group 1, at the end of therapy, 63.1% of patients had endometrial hyperplasia without atypia.


CONCLUSIONS
Ten milligrams mifepristone for three months is effective in reducing MBL, increasing haemoglobin and reducing uterine and leiomyoma volume with side-effect of endometrial hyperplasia.
Bagaria
Madhu
M
Department of Obstetrics and Gynaecology, University College of Medical Sciences, Delhi, India. madhu_bagaria@yahoo.co.in
Suneja
Amita
A
Vaid
Neelam B
NB
Guleria
Kiran
K
Mishra
Kiran
K
D000328:Adult; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004714:Endometrial Hyperplasia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005498:Follicular Phase; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D018231:Leiomyomatosis / Q000150:complications / Q000188:drug therapy*; D008595:Menorrhagia / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D010919:Placebos; D014594:Uterine Neoplasms / Q000150:complications / Q000188:drug therapy*
D006727:Hormone Antagonists; D010919:Placebos; D015735:Mifepristone