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Ulipristal acetate

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https://www.readbyqxmd.com/read/28742263/progesterone-receptor-modulators-for-endometriosis
#1
REVIEW
Jing Fu, Hao Song, Min Zhou, Huili Zhu, Yuhe Wang, Hengxi Chen, Wei Huang
BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (glands and stroma) outside the uterine cavity. This condition is oestrogen-dependent and thus is seen primarily during the reproductive years. Owing to their antiproliferative effects in the endometrium, progesterone receptor modulators (PRMs) have been advocated for treatment of endometriosis. OBJECTIVES: To assess the effectiveness and safety of PRMs primarily in terms of pain relief as compared with other treatments or placebo or no treatment in women of reproductive age with endometriosis...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#2
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28730840/the-safety-of-available-and-emerging-options-for-emergency-contraception
#3
Jessica K Lee, Eleanor Bimla Schwarz
Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expert Opinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown...
July 21, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28730656/spontaneous-pregnancy-during-ulipristal-acetate-treatment-of-giant-uterine-leiomyoma
#4
Z Hrgovic, D Habek, J Cerkez Habek, I Hrgovic, S Jerkovic Gulin, D Gulin
WHAT IS KNOWN AND OBJECTIVE: Ulipristal acetate, a progesterone receptor modulator, pharmacologically inhibits endometrial proliferation and thereby prevents pregnancy. It is primarily used as emergency contraception, but also for the treatment of fibroids in women of reproductive age. There have been no published cases of pregnancy, while on therapy with ulipristal acetate. CASE DESCRIPTION: In this article, we present a case report of spontaneous pregnancy during ulipristal acetate therapy...
July 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28721311/from-kaua-i-to-hawai-i-island-interisland-differences-in-emergency-contraceptive-pill-availability
#5
Holly Bullock, Mary Tschann, Jennifer Elia, Bliss Kaneshiro, Jennifer Salcedo
Emergency contraceptive pills (ECPs) are medications used after unprotected intercourse, underprotected intercourse, or sexual assault to decrease the risk of pregnancy. Availability of ECPs in Hawai'i's retail pharmacies was last assessed in 2007, following over-the-counter access to levonorgestrel ECPs (LNG-ECP) for women age 18 years or older and prior to U.S. Food and Drug Administration (FDA) approval of prescription-only ulipristal acetate (UPA). We conducted a county-by-county subanalysis from a larger observational population-based study on statewide availability of ECPs in Hawai'i's pharmacies...
July 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28676450/real-world-data-of-197-patients-treated-with-ulipristal-acetate-for-uterine-fibroids-premya-study-french-population-main-outcomes
#6
H Fernandez, P Descamps, M Koskas, P Lopès, J L Brun, E Darai, A Agostini
OBJECTIVES: To characterize and describe treatment with ulipristal acetate (UPA) in a preoperative setting and to evaluate the safety, effectiveness, and Health Related Quality of Life (HRQoL) outcomes in a French population treated according to standard clinical practice. MATERIALS AND METHODS: Multicentre, prospective, non-interventional study (PREMYA) of patients diagnosed with moderate to severe symptoms of uterine fibroids and undergoing a preoperative treatment with UPA 5mg (Esmya(®))...
July 1, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28663249/quick-starting-hormonal-contraception-after-using-oral-emergency-contraception-a-systematic-review
#7
REVIEW
Lauren Ee Murphy, Zhong E Chen, Valerie Warner, Sharon T Cameron
INTRODUCTION: Unprotected intercourse after oral emergency contraception (EC) significantly increases pregnancy risk. This underlies the importance of promptly starting effective, ongoing contraception - known as 'quick starting'. However, theoretical concern exists that quick starting might interact with EC or hormonal contraception (HC) potentially causing adverse side effects. METHOD: A systematic review was conducted, evaluating quick starting HC after oral EC [levonorgestrel 1...
June 29, 2017: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/28647614/inefficiency-of-ulipristal-acetate-on-uterus-leiomyomas-as-an-additional-sign-to-suspect-leiomyosarcoma
#8
P Kadhel, M Smail, D Borja De Mozota
The unexpected diagnosis of a leiomyosarcoma from a surgical specimen of a presumed leiomyoma is rare, but with deleterious consequences, especially if morcellation techniques are used. There are currently no effective methods for such a preoperative diagnosis. Ulipristal acetate has demonstrated efficacy for the preoperative treatment of leiomyomas, but not for all patients. We report two cases of leiomyosarcomas in patients treated with ulipristal acetate for a presumed leiomyoma. We propose that ineffective ulipristal acetate treatment may indicate a population in which uterine leiomyosarcoma is more prevalent...
June 21, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28631712/-the-molecular-mechanisms-and-morphological-manifestations-of-leiomyoma-reduction-induced-by-selective-progesterone-receptor-modulators
#9
T A Demura, Z V Revazova, E A Kogan, L V Adamyan
AIM: to investigate the molecular mechanisms and morphological substrate of reduced uterine leiomyoma in patients receiving the selective progesterone receptor modulator (SPRM) ulipristal acetate for 3 months, by estimating the immunohistochemical expression of the markers steroid receptor coactivator 1 (SRC-1), nuclear receptor corepressor 1 (NCoR-1), ER, PgR, Ki-67, p16, TGF-β, and VEGF in tumor tissue. SUBJECTS AND METHODS: The investigation enrolled 75 women with uterine leiomyoma, menorrhagias, and anemia...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28570936/a-uplc-ms-ms-method-for-the-quantitation-of-ulipristal-acetate-in-human-serum
#10
Renu Nandakumar, Piyapa Praditpan, Carolyn L Westhoff, Serge Cremers
The progesterone receptor modulator, Ulipristal acetate (UPA) has proven to be an effective emergency contraceptive. Conflicting data has been reported that suggests different efficacy of the drug in different populations, which may be explained by the systemic exposure to the drug. A UPLC-MS/MS method was developed and validated for the accurate and sensitive measurement of UPA in human serum to address this matter. UPA was extracted from human serum using liquid-liquid extraction with a combination of hexane and dichloromethane...
August 1, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28567743/the-use-of-selective-progestin-receptor-modulators-sprm-and-more-specifically-ulipristal-acetate-in-the-practice-of-gynaecology
#11
REVIEW
Serge Rozenberg, Julie Praet, Eliza Pazzaglia, Christine Gilles, Yannick Manigart, Jean Vandromme
This review discusses the development of selective progestin receptor modulators (SPRM) for use in women's health and specifically the use of ulipristal acetate (UPA) as emergency contraception (EC) and as a treatment for symptomatic fibroids in women who want to preserve their fertility or avoid a hysterectomy. As an EC, UPA 30 mg should be recommended for women, within 102 h of unprotected intercourse. As a treatment of fibroids, UPA (5 mg daily dose) should be administered for periods of three months as a pre-surgical strategy, reducing bleeding and fibroid size and facilitating surgery...
June 1, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28498002/an-observation-study-of-the-clinical-evaluation-of-symptom-relief-and-side-effects-associated-with-taking-ulipristal-acetate-esmya-including-its-effect-on-pre-menstrual-syndrome
#12
Bee F Chen, Martin C Powell, Courtney O'Beirne
This was an observational study investigating the efficacy and side effects associated with ulipristal acetate (UPA), a progesterone receptor modulator, and the possible benefits to women who have co-existing pre-menstrual syndrome (PMS). 80 women returned a questionnaire on the bleeding, menstrual pain and side effects, and changes on PMS were recorded. 67 women (84%) showed improvement in their menses. 54 women (67%) became amenorrhoeic. Of those, 67% were within 10 days of commencing UPA. Menses returned in 33 amenorrhoeic women within 4 weeks of stopping UPA...
May 12, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28485851/fibroid-vascularisation-as-a-predictor-for-uterine-fibroid-growth
#13
Margit Dueholm
There is a large variation in fibroid growth such that fibroids may grow at vastly different rates and conversely may spontaneously regress. The ability to predict the growth of fibroids could help clinicians decide, with their patients, the need for treatment. For example, asymptomatic women with fibroids detected incidentally may require follow up if these fibroids are predicted to have a high growth rate. In women of reproductive age, fast-growing fibroids located in a submucous or intramural position may subsequently impair fertility and so early surgical removal should be considered...
May 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28482329/endometrial-changes-during-ulipristal-acetate-use-a-systematic-review
#14
REVIEW
Inge De Milliano, Dominique Van Hattum, Johannes C F Ket, Judith A F Huirne, Wouter J K Hehenkamp
Ulipristal acetate is increasingly used for several clinical indications, like emergency contraception and pre-treatment of uterine fibroids. It has mixed progesterone agonist and antagonist effects in the myometrium and endometrium. Due to its progesterone antagonistic effect, an unopposed estrogen effect could occur which could cause (pre-)malignant lesions in the endometrium. Several studies have been performed to evaluate this possible increased risk for endometrial malignancies when using ulipristal acetate...
July 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28472576/ulipristal-acetate-an-update-for-australian-gps
#15
Danielle Mazza
BACKGROUND: In Australia, use and understanding of emergency contraception among women remains relatively low. This is despite the introduction of levonorgestrel emergency contraceptive pills (ECPs) more than a decade ago. In April 2016, a new ECP with the active ingredient ulipristal acetate became available in Australia. OBJECTIVE: The aims of this article are to increase understanding of the recently introduced ulipristal acetate ECP, including its safety profile, effi-cacy and special considerations; dispel common myths and misconceptions about emergency contraception; and to provide guidance on emergency contraceptive management in general practice, considering the recent advances...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28444736/selective-progesterone-receptor-modulators-sprms-for-uterine-fibroids
#16
REVIEW
Ally Murji, Lucy Whitaker, Tiffany L Chow, Mara L Sobel
BACKGROUND: Uterine fibroids are smooth muscle tumours arising from the uterus. These tumours, although benign, are commonly associated with abnormal uterine bleeding, bulk symptoms and reproductive dysfunction. The importance of progesterone in fibroid pathogenesis supports selective progesterone receptor modulators (SPRMs) as effective treatment. Both biochemical and clinical evidence suggests that SPRMs may reduce fibroid growth and ameliorate symptoms. SPRMs can cause unique histological changes to the endometrium that are not related to cancer, are not precancerous and have been found to be benign and reversible...
April 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28403922/place-of-ulipristal-acetate-in-the-management-of-uterine-fibroids-preoperative-treatment-or-sequential-treatment
#17
A-G Pourcelot, P Capmas, H Fernandez
Symptomatic uterine fibroids affect 25% of women of childbearing potential and are responsible for various symptoms, mainly menometrorrhagia, pelvic pain and infertility. No currently available medical treatment is able to eradicate fibroids. Two treatments are indicated preoperatively to reduce bleeding and decrease the size of fibroids: GnRH agonists and ulipristal acetate. Ulipristal acetate, a selective progesterone receptor modulator, exerts an antagonist effect on fibroid tissue, inducing apoptosis. It rapidly induces amenorrhoea (after an average of seven days of treatment) and reduces fibroid volume...
March 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28368774/pregnancy-outcomes-following-ulipristal-acetate-emergency-contraception-failure-a-report-of-five-cases
#18
Zeynep Ozturk, Emine Akgul
INTRODUCTION: The emergency contraceptive ulipristal acetate (UPA) 30 mg is increasingly used by women, but there is no published data on UPA exposure in pregnancy. CASE REPORT: Here we describe five cases of unintended pregnancies following the use of UPA for emergency contraception. Of five pregnant women exposed to UPA, one decided to terminate the pregnancy for personal reasons. Two of them experienced premature rupture of membranes and the babies were born large for gestational age (LGA)...
June 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28351762/does-ulipristal-acetate-affect-surgical-experience-at-laparoscopic-myomectomy
#19
Lea Luketic, Lindsay Shirreff, Sari Kives, Grace Liu, Ramadan El Sugy, Nicholas Leyland, Meir Jonathon Solnik, Ally Murji
STUDY OBJECTIVE: To compare surgical experience of laparoscopic/robotic myomectomy in premenopausal patients pretreated with ulipristal acetate (UPA) with women not hormonally pretreated. DESIGN: A retrospective, multicenter cohort study of laparoscopic/robotic myomectomy procedure videos (Canadian Task Force Classification III). SETTING: Multiple university-affiliated tertiary care hospitals. PATIENTS: Fifty-five premenopausal women who underwent laparoscopic/robotic myomectomy for intramural myomas and were either pretreated with 3 months of UPA or had no hormonal pretreatment...
March 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28292452/sometimes-you-do-get-a-second-chance-emergency-contraception-for-adolescents
#20
REVIEW
Ellen S Rome, Veronica Issac
Unplanned or unintended pregnancy remains a significant challenge for adolescents; many teens who plan ahead but opt not to choose long-acting reversible contraceptive methods have high failure rates with condom usage, oral contraceptives, and other less long-acting methods. Emergency contraception (EC) remains a necessity for those adolescents seeking a second chance to prevent the unintended consequences of unplanned sexual activity. At present, 5 postcoital methods remain available as EC globally: intrauterine devices, ulipristal acetate, a selective progesterone modulator, mifepristone; levonorgestrel, and ethinyl estradiol plus levonorgestrel or norgestrel (rarely used now that progestin only methods are more readily available)...
April 2017: Pediatric Clinics of North America
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