Medical Therapy for Fibroids: What Next for Ulipristal Acetate?

Advances in Therapy
Emmanuel Ekanem, Vikram Sinai Talaulikar

Abstract

Ulipristal acetate (UPA) was introduced as a novel progesterone receptor modulator as effective therapy for symptomatic fibroids. Randomised clinical trials established its effectiveness in the management of heavy menstrual bleeding due to uterine leiomyomas. The trials did not find any significant evidence of clinical harm to the participants. Recently, however, there have been reports of liver injury necessitating liver transplant in women who have had UPA treatment. This has led to the suspension of UPA as one of the medical therapies in the treatment for uterine fibroids while the European Medicines Agency (EMA) conducts a review of liver injury risk with its use. The European Medicine Agency safety committee has advised that women should stop taking 5 mg UPA and that no new patients should commence treatment with the medicine until the ongoing review is completed. In this article, we review the rise of UPA as one of the emerging medical therapies for symptomatic uterine fibroids and the subsequent reports of adverse events leading to the suspension of its use.

References

May 6, 2008·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Craig LammertNaga Chalasani
Jun 13, 2008·Best Practice & Research. Clinical Obstetrics & Gynaecology·Aradhana Khaund, Mary Ann Lumsden
Sep 6, 2011·International Journal of Women's Health·Nirmala Duhan
Feb 3, 2012·The New England Journal of Medicine·Jacques DonnezUNKNOWN PEARL I Study Group
Feb 3, 2012·The New England Journal of Medicine·Jacques DonnezUNKNOWN PEARL II Study Group
Aug 21, 2012·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Vikram Sinai Talaulikar, Isaac Manyonda
Aug 21, 2012·Advances in Therapy·Vikram S Talaulikar, Isaac T Manyonda
Feb 11, 2014·International Journal of Women's Health·Aamir T KhanJanesh K Gupta
Mar 19, 2014·Fertility and Sterility·Jacques DonnezUNKNOWN PEARL III and PEARL III Extension Study Group
Dec 30, 2014·Fertility and Sterility·Jacques DonnezErnest Loumaye
Nov 18, 2015·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Theodoros KalampokasEmmanouil Kalampokas
Dec 29, 2015·Journal of Minimally Invasive Gynecology·Simone FerreroUmberto Leone Roberti Maggiore
Feb 14, 2016·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Kristina Arendas, Nicholas A Leyland
Mar 30, 2017·Journal of Minimally Invasive Gynecology·Lea LuketicAlly Murji
Jul 22, 2017·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Fátima FaustinoFernanda Águas
Oct 27, 2017·Best Practice & Research. Clinical Obstetrics & Gynaecology·Vikram Sinai Talaulikar
Nov 25, 2017·Best Practice & Research. Clinical Obstetrics & Gynaecology·Jacques DonnezMarie-Madeleine Dolmans
Mar 13, 2018·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Natalie WoodheadPoonam Pradhan
May 1, 2018·Reproductive Biomedicine Online·Jacques DonnezMarie-Madeleine Dolmans
Sep 11, 2018·Fertility and Sterility·Jacques Donnez
Feb 19, 2019·Therapeutics and Clinical Risk Management·Manuela FarrisGiuseppe Benagiano
Jul 23, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Antonella BiscioneStefano Luisi
Aug 17, 2019·Journal of Minimally Invasive Gynecology·Clarissa FrascàRenato Seracchioli
Oct 28, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Simona Del FornoRenato Seracchioli

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