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Ulipristal Acetate: A Review in Symptomatic Uterine Fibroids

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Abstract

Oral ulipristal acetate (Esmya®; Fibristal®), a synthetic selective progesterone receptor modulator, is the first selective progesterone modulator to be approved for the treatment of uterine fibroids. It was initially approved for the preoperative treatment of moderate to severe uterine fibroid symptoms in women of reproductive age. Recently, the indication was extended in the EU to include the intermittent treatment of moderate to severe uterine fibroid symptoms. This narrative review summarizes pharmacological, efficacy and tolerability data relevant to the preoperative and intermittent use of ulipristal acetate in patients with symptomatic uterine fibroids. Ulipristal acetate is an effective and generally well tolerated treatment for patients with symptomatic uterine fibroids, both as preoperative, single-course treatment and as intermittent, longer-term treatment. It is noninferior in efficacy to intramuscular leuprolide acetate, as a preoperative treatment, and is associated with a lower rate of hot flashes, a common adverse event with gonadotropin-releasing hormone analogues. Thus, ulipristal acetate is an effective option for both preoperative and intermittent treatment of moderate to severe, symptomatic uterine fibroids in women of reproductive age.

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Acknowledgements

During the peer review process, the manufacturer of ulipristal acetate was also offered the opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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  1. Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand

    Karly P. Garnock-Jones & Sean T. Duggan

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  1. Karly P. Garnock-Jones
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Correspondence to Karly P. Garnock-Jones.

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Funding

The preparation of this review was not supported by any external funding.

Conflicts of interest

Karly P. Garnock-Jones and Sean T. Duggan are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/7698F0601D70CBC7.

Additional information

The manuscript was reviewed by: T. Al - Shawaf, Centre for Primary Care and Public Health, Barts and The London Medical College, Queen Mary University, London, UK; V. Brache, Biomedical Research Department, PROFAMILA, Santo Domingo, Dominican Republic; P. A. Orihuela, Universidad de Santiago de Chile, Santiago, Chile; S. Ferrero, DiNOGMI, University of Genova, Ospedale Policlinico San Martino, Genova, Italy.

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Garnock-Jones, K.P., Duggan, S.T. Ulipristal Acetate: A Review in Symptomatic Uterine Fibroids. Drugs 77, 1665–1675 (2017). https://doi.org/10.1007/s40265-017-0812-3

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  • DOI: https://doi.org/10.1007/s40265-017-0812-3

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