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A Alcalde Dominguez, J Rabasa Antonijuan, M Cusidó Gimferrer, M Jiménez Ortuño
Ulipristal acetate (UPA) is a medical therapy for patients with symptomatic uterine fibroids. The drug has shown efficacy in the control of heavy menstrual bleeding and, as a consequence, in anaemia improvement. We report the case of a hypertensive patient treated with two courses of UPA. In addition to its observed benefits on hypermenorrhea caused by uterine fibroids, no exacerbation of the underlying disease was observed. No adverse effects were observed, and blood pressure levels were well controlled throughout...
2018: Case Reports in Medicine
Mohamed Ali, Sara Mahmoud Shahin, Nagwa Ali Sabri, Ayman Al-Hendy, Qiwei Yang
BACKGROUND: Both European and American trials showed superior effect of ulipristal acetate (UPA) to placebo. However, the latter, which included black patients with known higher vitaminD3 deficiency risk, showed lower rate of amenorrhea responders and insignificant uterine fibroid (UF) size reduction. Our objective is to investigate whether adding vitamin D3 to UPA can enhance UPA potency on UF phenotype in vitro. METHODS: We screened the antiproliferative effect of different (UPA/vitaminD3) combinations on UF cell proliferation using dimethylthiazolyl diphenyltetrazolium bromide assay...
December 4, 2018: Reproductive Sciences
Meritxell Gracia, Roser Nonell, Cristina Ros, Mariona Rius, Lara Quintas, Maria Ángeles Martínez-Zamora, Francisco Carmona
OBJECTIVE: Ulipristal acetate (UPA) is a progesterone receptor modulator (PRM) agent that has shown benefits in women with symptomatic uterine fibroids. However, its effects on the endometrium are complex and not fully understood. We describe exploratory findings on macroscopic observation of the endometrium at transvaginal sonography (TVS) and hysteroscopy. The aim of the study is to characterize endometrial patterns commonly observed after UPA treatment. STUDY DESIGN: We performed a prospective longitudinal study at a tertiary referral center with 100 women with symptomatic uterine fibroids who received a 12-week treatment with UPA (5 mg/day)...
November 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jacques Donnez, Pablo Arriagada, Marcin Marciniak, Dominique Larrey
Uterine fibroids are benign tumours within the uterine wall affecting women. Ulipristal acetate 5 mg was first authorized in the European Union on 23 February 2012, with a post-marketing exposure estimated to be more than 750,000 patients so far. During the post-marketing experience, sporadic cases of liver injury and hepatic failure were reported. A detailed review of the clinical trials carried out in the development of Ulipristal acetate 5 mg was undertaken to further assess the liver safety data reported during the clinical trials...
November 21, 2018: Expert Opinion on Drug Safety
Carsten Möller, Wilhelm Bone, Arwed Cleve, Ulrich Klar, Andrea Rotgeri, Antje Rottmann, Marcus-Hillert Schultze-Mosgau, Andrea Wagenfeld, Wolfgang Schwede
Progesterone plays an important role in the female reproductive system. However, there is also evidence that gynecologic disorders/diseases such as uterine fibroids and endometriosis are progesterone-dependent. Steroidal and non-steroidal selective progesterone receptor modulators (SPRMs) have shown potential for the treatment of such diseases. Steroidal SPRMs, including mifepristone and ulipristal acetate, have proven effective in clinical trials. However, several steroidal SPRMs containing a dimethylamino substituent have been associated with elevated liver enzymes in patients...
November 6, 2018: ChemMedChem
Erica P Cahill, Paul D Blumenthal
PURPOSE OF REVIEW: To evaluate the literature on repeat use of emergency contraception and pericoital approaches to contraception. RECENT FINDINGS: Women are very interested in an oral, on-demand contraceptive option, were one available. Ulipristal acetate and a combination of levonorgestrel (LNG) and meloxicam (a cyclo-oxygenase-2 inhibitor) both appear to be more effective at disrupting ovulation than LNG alone. Recent advisories from the United Kingdom regarding daily dosing of ulipristal for fibroids emphasize the need for more safety data...
December 2018: Current Opinion in Obstetrics & Gynecology
N Hamdaoui, C Cardinale, A Agostini
OBJECTIVES: Edit, by the French National College of Gynecologists and Obstetricians (CNGOF), recommendations based on the evidence available in the literature for the use in terms of effectiveness, safety and side effects of emergency contraception (EC). METHODS: A review of the literature was conducted by consulting Medline, Cochrane Library and international recommendations in French and English from January 1, 1979 to May 1, 2018. RESULTS: It is recommended to inform patients that EC is not 100% effective...
October 30, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Francesca Conway, Giulia Morosetti, Sara Camilli, Francesco Giuseppe Martire, Giuseppe Sorrenti, Emilio Piccione, Errico Zupi, Caterina Exacoustos
Ulipristal acetate (UPA) is used for medical treatment of uterine fibroids. The aim of this study was to describe the effects on painful symptoms and the sonographic uterine modifications in patients with adenomyosis erroneously treated with UPA. This is an observational study on six women affected by adenomyosis and treated with three months of UPA (5 mg/24h). The baseline ultrasonography (US) was not performed at out center nor was the diagnosis of fibroids. The patients came to our attention after the treatment with UPA, prescribed by an external physician...
November 1, 2018: Gynecological Endocrinology
Valerie A French, Ariana V Rangel, Tateum L Mattingly
OBJECTIVE: To assess the accessibility of ulipristal acetate (UPA) and copper intrauterine devices (IUDs) for emergency contraception (EC) in reproductive health centers in the Kansas City metropolitan area. STUDY DESIGN: Using a secret shopper method, two female investigators called the reproductive health centers listed as EC providers on the nonprofit website that were located within 25 miles of the University of Kansas Medical Center. We categorized clinics as Title X providers vs...
December 2018: Contraception
Mostafa Nasr, Mohamed Farghaly, Tarek Elsaba, Mohamed El-Mokhtar, Radwa Radwan, Mahmoud Elsabahy, Ahmed Abdelkareem, Hussein Fakhry, Noha Mousa
Female sex steroid hormones have a fundamental role in breast cancer. Meanwhile, current evidence supports the contribution of breast cancer stem cells in carcinogenesis, metastasis, and resistance to cytotoxic chemotherapy. Nevertheless, the interaction between breast cancer stem cells with sex hormones or key hormonal antagonists remains elusive. OBJECTIVE: To investigate the effect of diverse sex hormonal stimulation and suppression regimens on the proliferation of a primary human breast cancer cells with stem cell activity...
October 22, 2018: International Journal of Biochemistry & Cell Biology
James H Liu, David Soper, Andrea Lukes, Phyllis Gee, Thomas Kimble, Robin Kroll, Madhuja Mallick, Anna Chan, Patrick Gillard, Amanda Harrington, Vilma Sniukiene, Lee P Shulman
OBJECTIVE: To assess the efficacy and tolerability of ulipristal acetate, a selective progesterone receptor modulator, for treatment of symptomatic uterine leiomyomas. METHODS: This phase 3, double-blind, double-dummy, placebo-controlled trial randomized premenopausal women (18-50 years) with uterine leiomyomas and abnormal uterine bleeding to once-daily 5 mg ulipristal, 10 mg ulipristal, or placebo in two 12-week treatment courses separated by a drug-free interval of two menses...
October 5, 2018: Obstetrics and Gynecology
(no author information available yet)
Safety alert : Esmya (ulipristal acetate) for symptoms of uterine fibroids: restrictions to use and requirement to check liver function before, during and after treatment.1,2.
November 2018: Drug and Therapeutics Bulletin
H Fernandez
No abstract text is available yet for this article.
November 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Melissa K Miller, Cynthia Mollen, Kelli Behr, M Denise Dowd, Elizabeth Miller, Catherine L Satterwhite, Stephani Stancil, Nancy Allen, Jeffery Michael, P Charles Inboriboon, Andrew Park, Kathy Goggin
OBJECTIVE: The objective was to develop an acceptable clinical decision support (CDS) system to facilitate evidence-based sexual health care for adolescents in the emergency department (ED). METHODS: In this multiphased iterative process, we engaged an expert group to synthesize evidence on a wide range of sexual health services (e.g., contraception, condoms, identification and treatment of previously diagnosed sexually transmitted infection). We created a computerized questionnaire and embedded our decision tree, utilizing patient-entered responses to create tailored, evidence-based recommendations, and embedded links to study-related resources such as the emergency contraception (EC) quick guide...
September 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sinnie Sin Man Ng, Soledad Jorge, Minnie Malik, Joy Britten, Szu-Chi Su, Charles R Armstrong, Joshua T Brennan, Sydney Chang, Kimberlyn Maravet Baig, Paul H Driggers, James H Segars
Context: Uterine leiomyomata (fibroids) are prevalent, sex hormone-dependent tumors with an altered response to mechanical stress. Ulipristal acetate, a selective progesterone receptor modulator (SPRM), significantly reduces fibroid size in patients. However, progesterone receptor signaling in fibroids and its relationship to mechanical signaling is incompletely understood. Objective: Our prior studies revealed that A-kinase Anchoring Protein 13 (AKAP13) was overexpressed in fibroids and contributed to altered mechanotransduction in fibroids...
September 14, 2018: Journal of Clinical Endocrinology and Metabolism
Jacques Donnez
No abstract text is available yet for this article.
September 2018: Fertility and Sterility
Rachel E Zigler, Tessa Madden, Caitlin Ashby, Leping Wan, Colleen McNicholas
OBJECTIVE: To evaluate whether ulipristal acetate reduces the number of bleeding days in etonogestrel implant users in a 30-day period as compared with placebo. METHODS: We performed a single-center, randomized, double-blind, placebo-controlled trial. Eligible participants were women aged 18-45 years with an etonogestrel implant in place for greater than 90 days and less than 3 years who reported greater than one bleeding episode in a 24-day period. Enrolled participants were randomized to receive 15 mg ulipristal acetate compared with an identical-appearing placebo daily for 7 days...
October 2018: Obstetrics and Gynecology
Alison B Edelman, Jeffrey T Jensen, Sara McCrimmon, Marci Messerle-Forbes, Andrea O'Donnell, Jon D Hennebold
OBJECTIVE: To determine if a combined oral contraceptive (COC) initiated shortly after ulipristal acetate (UPA) administration interferes with its mechanism of action. STUDY DESIGN: Healthy, reproductive-age women of normal BMI with proven ovulation (serum progesterone >3 ng/ml) were enrolled for three cycles (Cycle 1, UPA only; Cycle 2 washout; Cycle 3 UPA plus COC). During Cycles 1 and 3, subjects were monitored with transvaginal ultrasound and blood sampling for progesterone and LH every other day until a dominant follicle measuring >15 mm was visualized...
December 2018: Contraception
Cassandra De Gasperis-Brigante, Sukhbir S Singh, George Vilos, Sari Kives, Ally Murji
OBJECTIVE: To determine pregnancy and fetal outcomes following treatment with ulipristal acetate (UPA) for symptomatic uterine fibroids. METHODS: We conducted a systematic review and case series. We searched MEDLINE, EMBASE, PubMed, Web of Science, and Cochrane Register from inception to February 2017. From January 2014 to July 2017, we carried out a multi-centre retrospective chart review. All human studies that reported at least one pregnancy following UPA treatment were included...
August 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Angela Santoro, Giuseppe Angelico, Damiano Arciuolo, Frediano Inzani, Francesco Fanfani, Daniela Romualdi, Giovanni Scambia, Gian Franco Zannoni
INTRODUCTION: To study the clinical, pathological and therapeutic implications of ulipristal acetate (UPA) treatment failure in patients affected by uterine smooth muscle tumors. CASE PRESENTATION: Two patients affected by uterine leiomyosarcoma were preoperatively diagnosed as uterine leiomyomas and, thus, treated conservatively with UPA and morcellation. Both patients experienced a worsening of symptoms (persistent bleeding) after 3 month of treatment with UPA...
August 2018: Medicine (Baltimore)
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