title: Ulipristal acetate: a novel pharmacological approach for the treatment of uterine fibroids.
abstract: Uterine fibroids are the most common benign tumors of the female genital tract. The management of symptomatic fibroids has traditionally been surgical; however, alternative pharmacological approaches have been proposed to control symptoms. To date, gonadotropin-releasing hormone analogs are the only available drugs for the preoperative treatment of fibroids. However, the US Food and Drug Administration recently authorized ulipristal acetate (UPA), an oral selective progesterone-receptor modulator, for the same indication. UPA is a new, effective, and well-tolerated option for the preoperative treatment of moderate and severe symptoms of uterine fibroids in women of reproductive age. According to clinical data, UPA shows several advantages: it is faster than leuprolide in reducing the fibroid-associated bleeding, it significantly improves hemoglobin and hematocrit levels in anemic patients, and it grants a significant reduction in the size of fibroids, which lasts for at least 6 months after the end of the treatment. Furthermore, UPA displays a better tolerability profile when compared to leuprolide; in fact, it keeps estradiol levels at mid follicular phase range, thereby reducing the incidence of hot flushes and exerting no impact on bone turnover. On the grounds of this evidence, the administration of 5 mg/day ulipristal acetate for 3 months is suggested for different patient categories and allows for planning a treatment strategy tailored to meet an individual patient's needs.
authors.affiliation: Department of Obstetrics and Gynaecology, Mauriziano "Umberto I" Hospital, University of Turin, Turin, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.affiliation: Department of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Silvestro
authors.initials: S
authors.lastname: Carinelli
authors.affiliation: Department of Obstetrics and Gynecology, ARNAS Civico Hospital, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Maiorana
authors.affiliation: Department of Obstetrics and Gynaecology, Mauriziano "Umberto I" Hospital, University of Turin, Turin, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: D'Alonzo
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, Infertility Unit, University of Ferrara, Ferrara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Monte
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, Infertility Unit, University of Ferrara, Ferrara, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marci
mesh_terms: D004717:Endometrium / Q000187:drug effects; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy*; D009649:Norpregnadienes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D009649:Norpregnadienes; C555622:ulipristal acetate
keywords: medical treatment of uterine fibroids; myomas; selective progesterone-receptor modulator; ulipristal acetate; uterine fibroids