Role of ulipristal acetate in management of uterine fibroid
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243627Keywords:
Ulipristal acetate, UPA, Uterine fibroid, Medical management, Liver function test, Selective progesterone receptor modulatorAbstract
Uterine fibroids are most common benign tumors in women of reproductive age group. Prevalence in rural population in India is 37.65% and 24% in urban population. Management depends on number, size, location of fibroid, patients age and fertility preservation. Ulipristal acetate is an orally active synthetic selective progesterone receptor modulator (SPRM). It competes at the progesterone binding site in a tissue specific manner. It decreases fibroid size and relieves symptoms. It inhibits cell proliferation and induces apoptosis leading to shrinkage of tumor. It is indicated for pre-operative treatment and for those who wish to preserve fertility. It is given as four intermittent courses of 5 mg once daily for 3 months. Liver function test has to be done prior to each course. Hence, ulipristal acetate is a promising non-surgical treatment alternative for women with symptomatic uterine fibroids, particularly for those who are not candidates for surgery or who prefer a less invasive approach.
Metrics
References
Datir SG, Bhake A. Management of Uterine Fibroids and Its Complications During Pregnancy: A Review of Literature. Cureus. 2022;14(11):e31080.
Donnez J, Tatarchuk TF, Bouchard P, Puscasiu L, Zakharenko NF, Ivanova T, et al; PEARL I Study Group. Ulipristal acetate versus placebo for fibroid treatment before surgery. N Engl J Med. 2012;366(5):409-20.
Donnez J, Dolmans MM. Uterine fibroid management: from the present to the future. Hum Reprod Update. 2016;22(6):665-86.
Singh SS, Belland L, Leyland N, von Riedemann S, Murji A. The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids. Am J Obstet Gynecol. 2018;218(6):563-72.
Ekanem E, Talaulikar V. Medical Therapy for Fibroids: What Next for Ulipristal Acetate? Adv Ther. 2021;38:137-48.
Ulipristal acetate for fibroids. Aust Prescr. 2016;39(6):230-1.
Donnez J, Tomaszewski J, Vázquez F, Bouchard P, Lemieszczuk B, Baró F, et al; PEARL II Study Group. Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med. 2012;366(5):421-32.
Indian Prespective. A FOGSI President’s Initiative- Key Practice Points on Fibroids. 2019. Available at: https://www.fogsi.org/wp-content/uploads/tog/KPP_ Key_Practice_Points_on_Fibroids_Final.pdf. Accessed on 12 August 2024.
