title: Selective progesterone receptor modulators in reproductive medicine: pharmacology, clinical efficacy and safety.
abstract: OBJECTIVE
  To discuss the mechanism of action of selective progesterone receptor modulators (SPRMs) and summarize the preclinical and clinical efficacy and safety data supporting the potential use of these compounds for gynecologic indications.
  
  
  METHODS
  Relevant publications from 2005 onward were identified using a PubMed search. Additional relevant articles were identified from citations within these publications.
  
  
  METHODS
  None.
  
  
  METHODS
  None.
  
  
  METHODS
  None.
  
  
  METHODS
  None.
  
  
  RESULTS
  Mifepristone was first developed as a progesterone receptor antagonist and licensed for pregnancy termination because of the unique property of this compound to terminate pregnancy when associated with prostaglandins. Then SPRMs were developed, and among those ulipristal acetate, an efficient emergency contraceptive. Because SPRMs effectively inhibit endometrial proliferation and reduce endometriotic lesions in animal models, this suggests a possible role in the treatment of endometriosis in humans. Finally, a number of double-blind, randomized, placebo-controlled trials have demonstrated the efficacy of asoprisnil, mifepristone, telapristone acetate, and ulipristal acetate in reducing leiomyoma and uterine volume, and suppressing bleeding in women with uterine fibroids.
  
  
  CONCLUSIONS
  Mifepristone in combination with prostaglandins has been licensed for pregnancy termination because of its unique ability is this area. Ulipristal acetate is available for emergency contraception. Several SPRMs hold further promise as an effective medical therapy for patients suffering from endometriosis and leiomyoma.
authors.affiliation: Endocrinology Unit, AP-HP Hospital Saint-Antoine, Paris, France. philippe.bouchard@sat.aphp.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Bouchard
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chabbert-Buffet
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
mesh_terms: D000019:Abortifacient Agents / Q000627:therapeutic use; D000028:Abortion, Induced; D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D044363:Contraception, Postcoital; D003281:Contraceptives, Postcoital / Q000627:therapeutic use; D004715:Endometriosis / Q000188:drug therapy / Q000378:metabolism; D019317:Evidence-Based Medicine; D005260:Female; D006727:Hormone Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy; D011247:Pregnancy; D011980:Receptors, Progesterone / Q000037:antagonists & inhibitors* / Q000378:metabolism; D012098:Reproduction / Q000187:drug effects*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy
chemical_list: D000019:Abortifacient Agents; D018931:Antineoplastic Agents, Hormonal; D003281:Contraceptives, Postcoital; D006727:Hormone Antagonists; D011980:Receptors, Progesterone