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Ulipristal acetate

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https://www.readbyqxmd.com/read/29338440/selective-progesterone-receptor-modulators-current-applications-and-perspectives
#1
N Chabbert-Buffet, K Kolanska, E Daraï, P Bouchard
Selective progesterone receptor modulators (SPRMs) are steroid progesterone receptor ligands able to induce agonistic or antagonistic activities. Mifepristone, the class leader, was primarily used for pregnancy termination from the 1980s. Emergency contraception with extended activity was the second major development 30 years later, with mifepristone in some countries and ulipristal acetate world-wide. More recently, ulipristal acetate was released for the treatment of myoma-related uterine bleeding. In addition to a very rapid cessation of bleeding, SPRMs allow a decrease in myoma volume, as do gonadotropin releasing hormone analogs...
January 17, 2018: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/29328939/outcome-of-patients-with-uterine-fibroids-after-3-month-ulipristal-acetate-therapy
#2
Jean-Luc Brun, José Rajaonarison, Alizée Froeliger, Anne-Coline Monseau-Thiburce, Rado Randriamboavonjy, Andrej Vogler
OBJECTIVES: To determine the proportion and the characteristics of patients who did or did not respond after 3 months of ulipristal acetate (UPA) therapy. STUDY DESIGN: In this retrospective cohort study conducted in the University Hospital of Bordeaux (France) and University Medical Center Ljubljana (Slovenia), symptomatic non-menopausal patients with fibroids that qualified for surgery were pretreated by 3 months of oral UPA 5 mg/day. Clinical success was defined by normalization of the bleeding score, and/or regression of pelvic pain, and/or abdominal distension...
December 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29298791/non-surgical-intervention-for-retroperitoneal-lymphogenic-and-pulmonary-metastases-of-a-benign-leiomyoma-treatment-with-ulipristal-acetate
#3
Kim E Kortekaas, Harold M P Pelikan
This case report describes a very rare coexistence of retroperitoneal lymphogenic and pulmonary metastases of a benign leiomyoma: benign metastasising leiomyoma (BML). Despite surgical treatment growth of multiple nodules in the lungs, omentum, mesenterium and retroperitoneum was observed by CT scan. We started off-label ulipristal acetate treatment with impressive results. The lesions on the CT scan disappeared, and the patient was asymptomatic after treatment.
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29260904/ulipristal-acetate-for-the-management-of-acute-heavy-menstrual-bleeding-without-fibroids
#4
Josep Estadella, Pia Español, Fiorella Ascencio, Josep Perelló, Joaquim Calaf
Heavy menstrual bleeding is a common condition among women of childbearing age. Although hysterectomy was the usual approach in acute cases in the past, other minimally invasive therapies or pharmacological alternatives, such as the levonorgestrel intrauterine device have shown to be highly effective. This case report presents the case of a pluripathological patient with acute heavy menstrual bleeding and severe anemia, who was successfully managed with ulipristal acetate, a selective progesterone receptor modulator...
December 20, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29250979/pharmacokinetic-drug-evaluation-of-ulipristal-acetate-for-the-treatment-of-uterine-fibroids
#5
Simone Ferrero, Valerio Gaetano Vellone, Fabio Barra
Uterine fibroids are the most common form of benign gynecological tumors in women of reproductive ages. Although surgery is the main option to treat them, alternative pharmacological approaches are being investigated to control their symptoms. Among them, ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term treatment of uterine fibroids. Areas covered: The aim of this article is to review the literature on the pharmacodynamics, pharmacokinetics (PK), clinical efficacy and safety of UPA for the treatment of uterine fibroids...
January 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29241443/characterization-of-molecular-changes-in-endometrium-associated-with-chronic-use-of-progesterone-receptor-modulators-ulipristal-acetate-versus-mifepristone
#6
Athilakshmi Kannan, Arpita Bhurke, Regine Sitruk-Ware, Parameswaran G Lalitkumar, Kristina Gemzell-Danielsson, Alistair R W Williams, Robert N Taylor, Milan K Bagchi, Indrani C Bagchi
Ulipristal acetate (UPA) is a selective progesterone receptor modulator (PRM), which is used as an emergency contraceptive in women. Recent studies demonstrated the efficacy of an UPA contraceptive vaginal ring (UPA-CVR) as a blocker of ovulation. However, the endometrium of women exposed to UPA over a 6-month period display glandular changes, termed PRM-associated endometrial changes (PAECs). We, therefore, investigated whether UPA-induced PAECs are associated with altered expression of the transcription factor heart- and neural crest derivatives-expressed protein 2 (HAND2) whose downregulation is observed in endometrial epithelial hyperplasia and cancer...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29227976/progesterone-receptor-isoforms-nuclear-corepressor-1-and-steroid-receptor-coactivator-1-and-b-cell-lymphoma-2-and-akt-and-akt-phosphorylation-status-in-uterine-myomas-after-ulipristal-acetate-treatment-a-systematic-immunohistochemical-evaluation
#7
Guillaume E Courtoy, Jacques Donnez, Etienne Marbaix, Matilde Barreira, Mathieu Luyckx, Marie-Madeleine Dolmans
OBJECTIVE: To investigate whether ulipristal acetate (UPA) treatment modifies the expression of progesterone receptor (PR), its nuclear cofactors steroid receptor coactivator-1 (SRC1) and nuclear corepressor-1 (NCoR1), prosurvival factor B-cell lymphoma 2 (Bcl-2), and Akt in uterine myomas. PATIENTS: Prospective study of 59 women with symptomatic myomas undergoing myomectomy. Forty-two patients were treated preoperatively with UPA; the remaining 17 were not and they served as controls...
December 11, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/29199806/selective-progesterone-receptor-modulators-new-possibilities-for-gynecologic-hormone-therapy
#8
Nanna Sarvilinna, Leila Unkila-Kallio, Päivi Härkki, Aila Tiitinen, Oskari Heikinheimo
Progesterone regulates several female reproductive functions. Progesterone and synthetic progestins derived from it have long been utilized in gynecology. The effects of these steroids in target cells are mediated via progesterone receptors, Progesterone receptors are also the target of action of selective progesterone receptor modulators. Of the molecules of this newer group of drugs, two are presently in clinical use. Mifepristone is used in nonsurgical abortion, in softening of the cervix before surgical abortion, and in the induction of labor in cases of intrauterine death...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29186429/extracellular-matrix-in-uterine-leiomyoma-pathogenesis-a-potential-target-for-future-therapeutics
#9
Md Soriful Islam, Andrea Ciavattini, Felice Petraglia, Mario Castellucci, Pasquapina Ciarmela
BACKGROUND: Uterine leiomyoma (also known as fibroid or myoma) is the most common benign tumor of the uterus found in women of reproductive age. It is not usually fatal but can produce serious clinical symptoms, including excessive uterine bleeding, pelvic pain or pressure, infertility and pregnancy complications. Due to lack of effective medical treatments surgery has been a definitive choice for the management of this tumor. OBJECTIVE AND RATIONALE: Extracellular matrix (ECM) accumulation and remodeling are thought to be crucial for fibrotic diseases such as uterine leiomyoma...
January 1, 2018: Human Reproduction Update
https://www.readbyqxmd.com/read/29169896/the-current-place-of-medical-therapy-in-uterine-fibroid-management
#10
REVIEW
Jacques Donnez, Olivier Donnez, Marie-Madeleine Dolmans
Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid "radical" surgery. Surgical and non-surgical approaches include hysterectomy myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization, and magnetic resonance-guided focused ultrasound surgery. The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility...
October 22, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#11
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138584/repeated-intermittent-ulipristal-acetate-in-the-treatment-of-uterine-fibroids-a-cost-effectiveness-analysis
#12
Kirk Geale, Ertan Saridogan, Matthieu Lehmann, Pablo Arriagada, Marcus Hultberg, Martin Henriksson
There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg (UPA) is an effective treatment for this patient group, but its cost-effectiveness has not been assessed in this population. A decision-analytic model was developed to simulate a cohort of patients in this population under treatment with UPA followed by surgery as needed compared to treatment with iron and non-steroidal anti-inflammatory drug (NSAID) followed by surgery as needed (best supportive care, BSC)...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29121217/effect-of-ulipristal-acetate-and-mifepristone-at-emergency-contraception-dose-on-the-embryo-endometrial-attachment-using-an-in-vitro-human-trophoblastic-spheroid-and-endometrial-cell-co-culture-model
#13
Hang-Wun Raymond Li, Ying-Xing Li, Tian-Tian Li, Hongjie Fan, Ernest Hung-Yu Ng, William Shu-Biu Yeung, Pak-Chung Ho, Kai-Fai Lee
STUDY QUESTION: Do both ulipristal acetate (UPA) and mifepristone inhibit embryo-endometrial attachment at concentrations corresponding to the emergency contraception (EC) dose? SUMMARY ANSWER: Both UPA and mifepristone at concentrations corresponding to the EC dose do not have an inhibitory effect on embryo implantation, although mifepristone at a higher concentration appeared to have such an effect. WHAT IS KNOWN ALREADY: Levonorgestrel is commonly used for EC, but it only acts through inhibition of ovulation...
November 7, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29108079/prevalence-and-correlates-of-emergency-contraceptive-use-in-transitional-albania
#14
Dajana Roshi, Salvatore Italia, Genc Burazeri, Helmut Brand
Objectives The two emergency contraceptive drugs ("morning-after pill") ulipristal acetate and levonorgestrel are available without prescription in many European countries. In Albania, ulipristal acetate is not marketed yet and levonorgestrel has still prescription-only status. The objective of this study was to assess the prevalence and socioeconomic correlates of emergency contraceptive (EMC) use, collect sales figures, and gain information on the women's way of purchasing EMCs in post-communist Albania. Methods For this cross-sectional study, self-administered questionnaires were made accessible to women in Albania in March 2015 by hard copy or online via social networks...
November 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29105584/is-ulipristal-acetate-the-new-drug-of-choice-for-the-medical-management-of-uterine-fibroids-res-ipsa-loquitur
#15
Funlayo Odejinmi, Reeba Oliver, Rebecca Mallick
Ulipristal acetate (Esmya(©)) has been hailed the new wonder drug with regard to the medical management of uterine fibroids, and many postulate that it will remove the need for surgical treatment in the future. While the results from the PEARL studies are certainly promising and its amenorrhoeic rates and reduction in fibroid size are unquestionable, there is still a paucity of data with regard to its long-term effects, the effects on its usage prior to surgery and its variable efficacy in different ethnic populations...
November 1, 2017: Women's Health
https://www.readbyqxmd.com/read/29102184/determination-of-progestogens-in-surface-and-waste-water-using-spe-extraction-and-lc-apci-appi-hrps
#16
Oksana Golovko, Pavel Šauer, Ganna Fedorova, Hana Kocour Kroupová, Roman Grabic
The aim of this study was to develop a reliable analytical method for the measurement of 17 selected progestogens in waste water and surface water. Automated whole water solid phase extraction (SPE) was used for sample concentration. Liquid chromatography tandem atmospheric pressure chemical ionization/atmospheric pressure photoionization with hybrid quadrupole/orbital trap mass spectrometry operated in high resolution product scan mode (LC-APCI/APPI-HRPS) was applied for the analyses. The whole-method recoveries ranged from 60% to 140% for all analytes at two different spike levels (5 and 50ng/L) in the studied matrices...
October 25, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29097224/pharmacy-access-to-ulipristal-acetate-in-major-cities-throughout-the-united-states
#17
Maryssa Shigesato, Jennifer Elia, Mary Tschann, Holly Bullock, Eric Hurwitz, Yan Yan Wu, Jennifer Salcedo
OBJECTIVE: Ulipristal acetate (UPA) is a prescription emergency contraceptive pill (ECP). Despite the potential for UPA to reduce the risk of unintended pregnancies, a recent study in Hawaii demonstrated less than 3% of pharmacies stocked UPA and less than 23% reported the ability to order it. The primary outcome of our study was to assess the availability of UPA in a sample of large cities nationwide. STUDY DESIGN: We conducted a telephone-based secret shopper study of 533 retail pharmacies sampled proportionally from ten large cities in five geographic regions across the US...
October 30, 2017: Contraception
https://www.readbyqxmd.com/read/29079463/a-multicenter-study-evaluating-the-effect-of-ulipristal-acetate-during-myomectomy
#18
Ally Murji, Marta Wais, Sabrina Lee, Alice Pham, Melissa Tai, Grace Liu
STUDY OBJECTIVE: To compare surgical experience at myomectomy between patients with myomas pretreated with ulipristal acetate versus no pretreatment. DESIGN: A prospective, observational, multicenter study of myomectomy procedures by any route (hysteroscopic, laparoscopic, or laparotomy) (Canadian Task Force classification II-2). SETTING: Five university-affiliated hospitals including tertiary care and community sites. PATIENTS: Any patient who underwent hysteroscopic, laparotomic, or laparoscopic myomectomy regardless of medical pretreatment...
October 24, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29036770/emergency-contraception-oral-and-intrauterine-options
#19
Kirsten I Black, Safeera Y Hussainy
BACKGROUND: Emergency contraception can be used to prevent pregnancy where contraception has not been used, or there has been contraceptive misuse or failure. Australian women have three options for emergency contraception: two types of oral pills (levonorgestrel [LNG]-containing pill and ulipristal acetate [UPA]) and the copper intrauterine device (IUD). Both pills are available from pharmacies without prescription, whereas the copper IUD requires insertion by a trained provider. OBJECTIVE: The objective of this article is to describe the indications, efficacy and contraindications for use of the three emergency contraceptive methods available in Australia...
October 2017: Australian Family Physician
https://www.readbyqxmd.com/read/29036173/pre-treatment-with-gnrha-or-ulipristal-acetate-prior-to-laparoscopic-and-laparotomic-myomectomy-a-systematic-review-and-meta-analysis
#20
REVIEW
Inge de Milliano, Moniek Twisk, Johannes C Ket, Judith A Huirne, Wouter J Hehenkamp
BACKGROUND: Myomectomy has potential risks of complications. To reduce these risks, medical pre-treatment can be applied to reduce fibroid size and thereby potentially decrease intra-operative blood loss, the need for blood transfusion and emergency hysterectomy. The aim of this systematic review and meta-analysis is to study the effectiveness of medical pre-treatment with Gonadotropin-releasing hormone agonists (GnRHa) or ulipristal acetate prior to laparoscopic or laparotomic myomectomy on intra-operative and post-operative outcomes...
2017: PloS One
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