title: [Ulipristal acetate, 5mg: a new alternative].
abstract: Fibroids have a high prevalence (approaching 50%) in the female population. Although they are a benign entity, they represent a health problem of considerable magnitude, causing hemorrhaging, pain and sterility. Surgical treatment is currently safe and effective, but in recent decades numerous less invasive alternatives have appeared, such as uterine artery embolization and thermal ablation (HIFU and radiofrequency). New possibilities for medical treatment have also emerged, such as GnRh analogues, aromatase inhibitors and selective progesterone receptor modulators (SPRMs). SPRMs act through progesterone receptors and behave as agonists or antagonists in various target organs. Among them, ulipristal acetate (UA) inhibits the proliferation and induction of apoptosis and cell death pathways in leiomyoma cells, translating at the clinical level to smaller fibroids and lower uterine volumes, with no significant side effects. UA also produces amenorrhea in most patients. Randomized, phase III (PEARL I and II) clinical trials have shown the efficacy and security of UA versus placebo and leuprolide acetate (LA). UA is similar to LA, and superior to placebo in controlling bleeding and decreasing the size of the fibroid, with fewer side effects than LA. The safety and tolerance of UA have been satisfactory. UA is a reality in the preoperative treatment of fibroids, with broad potential for further development.
authors: Servicio de Ginecología, Hospital Politécnico y Universitario La Fe, Valencia, España. Electronic address: monleon_javsan@gva.es.
authors: Javier
authors: J
authors: Monleón Sancho
authors: Eugenia
authors: E
authors: Romaguera
authors: Ainhoa
authors: A
authors: Romero
authors: Gema
authors: G
authors: Higueras
authors: Inmaculada
authors: I
authors: Morcillo
authors: Sonia
authors: S
authors: Fuster
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy*; D009649:Norpregnadienes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009649:Norpregnadienes; C555622:ulipristal acetate
keywords: Acetato de ulipristal; Conservative treatment; ESMYA; Esmya; Fibroid; Mioma; Preoperative treatment; SPRM; Tratamiento conservador; Tratamiento prequirúrgico; Ulipristal acetate