title: Ulipristal acetate for uterine fibroids: a systematic review and meta-analysis.
abstract: Ulipristal acetate (UA), a selective progesterone modulator, has been approved for short-term therapy for symptomatic fibroids. We decided to undertake a systematic review of the best available evidence and draw a more definitive conclusion regarding the efficacy of UA for the management of uterine fibroids. The outcomes included symptomatic relief, quality of life-related parameters, reduction in fibroid size, side effects and recurrence rate. We included four randomised controlled trials which consisted of three trials which compared UA with placebo, and one trial compared it with gonadotropin-releasing hormone analogues for symptomatic relief. The three trials comparing UA with placebo reported significant improvement in symptoms related to excessive uterine bleeding as evidenced by the attainment of amenorrhea or reduction in pictorial blood assessment chart. However, due to the heterogeneity of the available data, a meta-analysis was possible only for one the outcomes - attainment of amenorrhea which indicated improvement in symptoms [57.88 (19.81-169.16); p < 0.00001]. The improved quality of life parameters and reduction in fibroid size was noted in the UA group. With regards to adverse events, even though the three included studies reported increased non-physiological endometrial-related changes following UA, these changes reverted back to normal within 6 months. Short-term use of UA seems to be an effective and safe method of treating uterine fibroids.
authors.affiliation: a Second Department of Obstetrics and Gynecology, University of Athens, "Aretaieion" Hospital , Athens , Greece .
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kalampokas
authors.affiliation: b Reproductive Medicine Unit, Christian Medical College , Vellore, Tamil Nadu , India , and.
authors.forename: Mohan
authors.initials: M
authors.lastname: Kamath
authors.affiliation: a Second Department of Obstetrics and Gynecology, University of Athens, "Aretaieion" Hospital , Athens , Greece .
authors.forename: Ioannis
authors.initials: I
authors.lastname: Boutas
authors.affiliation: c Gynaecological Oncology Department, University of Aberdeen , Aberdeen , UK.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Kalampokas
mesh_terms: D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy*; D009649:Norpregnadienes / Q000009:adverse effects / Q000494:pharmacology*; D011980:Receptors, Progesterone / Q000378:metabolism*; D014594:Uterine Neoplasms / Q000188:drug therapy*
chemical_list: D009649:Norpregnadienes; D011980:Receptors, Progesterone; C555622:ulipristal acetate
keywords: Acetate; fibroids; myomas; ulipristal