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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.
October 8, 2018: Drug and Therapeutics Bulletin
H Fernandez
No abstract text is available yet for this article.
October 4, 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: 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 multi-phased 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...
August 14, 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)
Na Gan, Qiaomei Sun, Man Zhang, Peixiao Tang, Ludan Zhao, Tonghui Xie, Yongkui Zhang, Hui Li
Interaction between ulipristal acetate (UPA) and human serum albumin (HSA) was investigated in simulated physiological environment using multi-spectroscopic and computational methods. Fluorescence experiments showed that the quenching mechanism was static quenching, which was confirmed by the time-resolved fluorescence. Binding constants (Ka ) were found to be 1 × 105 L mol-1 , and fluorescence data showed one binding site. Thermodynamic constants suggested the binding process was mainly controlled by electrostatic interactions...
July 30, 2018: Journal of Biomolecular Structure & Dynamics
So-Jin Shin, Jinyoung Kim, Seungmee Lee, Jongwoo Baek, Jin Eui Lee, Chiheum Cho, Eunyoung Ha
Uterine leiomyoma is a benign tumor that grows within the muscle tissue of the uterus. Ulipristal acetate (UPA) is a pre‑operative drug used to reduce the size of leiomyoma. The aim of the present study was to examine the in vitro mechanistic details of action of UPA on uterine leiomyomas. Primary cultures of leiomyoma cells were isolated from patient myomectomy specimens and incubated in the presence or absence of UPA at various concentrations. The proliferation, cell viability and doubling time properties of the treated cells were analyzed...
October 2018: International Journal of Molecular Medicine
Jorge E Shortrede, Maria M Montt-Guevara, Gisela Pennacchio, Michele Finiguerra, Andrea Giannini, Alessandro D Genazzani, Tommaso Simoncini
Ulipristal acetate (UPA) is a selective progesterone receptor modulator (SPRM) used for emergency contraception and for the medical management of symptomatic uterine fibroids (UF). Treatment with UPA turns in amenorrhea and UF volume reduction. Treatment with UPA is associated with the frequent development of benign, transitory endometrial changes known as SPRM-associated endometrial changes (PAECs). Why PAECs develop and their biological or cellular basis is unknown. Sex steroids, including estrogen and progesterone, are established modulators of the actin cytoskeleton in various cells, including endometrial cells...
2018: Frontiers in Endocrinology
Benjamin J G Illingworth, Martin Hirsch, James M N Duffy
No abstract text is available yet for this article.
July 2018: Obstetrics and Gynecology
Benjamin Tuschy, Mirja Gabbert, Christel Weiss, Amadeus Hornemann, Anne Wuhrer, Marc Sütterlin, Sebastian Berlit
OBJECTIVE: To evaluate changes in sexuality in women treated with Ulipristal acetate (UPA) due to symptomatic uterine fibroids. STUDY DESIGN: A total of 102 women with symptomatic uterine fibroids undergoing conservative therapy with UPA were enrolled in this observational study. Sexuality was evaluated before and after a three month UPA treatment using the Female Sexual Functioning Index (FSFI) as well as the Sexual Activity Questionnaire (SAQ). Before treatment was initiated, participants additionally filled in a standardised questionnaire addressing the expected changes in sexuality due to UPA...
September 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
W Elger, B Schneider, Z Killeen, K Jewgenow, M Dehnhard, M Friedrich, B Santhamma, R Wedemeyer, K Nickisch
A guinea pig model for new HEC methods is proposed. Two targets for HEC (Hormonal Emergency Contraception), ovulation and conception (post-mating study), were investigated using adjusted PRM treatments: (a) Ovulation inhibition study: Injections on cycle days 10-17, study of ovarian histology on day 18; (b) post-mating study: Injections on cycle days 1 and 2; rate of pregnant females was recorded at autopsy on day 18. P plasma levels permitted assessment of effects on ovulation in non-conceiving animals. RESULTS: (a) All controls had recently ovulated...
October 2018: Journal of Steroid Biochemistry and Molecular Biology
S Oscoz-Jaime, M Larrea-García, M J Mitxelena-Eceiza, N Abián-Franco
No abstract text is available yet for this article.
May 31, 2018: Actas Dermo-sifiliográficas
Piotr Czuczwar, Anna Stepniak, Pawel Milart, Tomasz Paszkowski, Slawomir Wozniak
BACKGROUND: To assess and compare the influence of three fibroid treatment options: supracervical hysterectomy, ulipristal acetate and uterine artery embolization on ovarian reserve. METHODS: Prospective, observational, open-label study performed at the 3rd Chair and Department of Gynecology of the Medical University of Lublin, Poland. Premenopausal Caucasian women with symptomatic uterine fibroids were recruited into 3 groupspatients qualified for supracervical hysterectomies; patients qualified for preoperative ulipristal acetate (UPA) treatment scheduled for supracervical hysterectomies or myomectomies; patients qualified for uterine artery embolization (UAE)...
June 1, 2018: Journal of Ovarian Research
Guillaume E Courtoy, Jacques Donnez, Jérôme Ambroise, Pablo Arriagada, Mathieu Luyckx, Etienne Marbaix, Marie-Madeleine Dolmans
RESEARCH QUESTION: Does ulipristal acetate (UPA) modify the expression of genes related to apoptosis or the extracellular matrix in uterine myomas and are any modifications associated with a clinical response? DESIGN: Targeted analysis of 176 apoptosis- or extracellular-matrix-related genes was conducted using polymerase chain reaction (PCR) arrays. Relevant results were validated by quantitative PCR. Four groups were established: responsive short-term (one course, n = 9), responsive long-term (two to four courses, n = 9), non-responsive (n = 9), and the control group who was not given any hormone therapy (n = 9)...
August 2018: Reproductive Biomedicine Online
Jack Charles Collins, Carl Richard Schneider, Rebekah Jane Moles
OBJECTIVE: To explore the supply of emergency contraception (EC) from Australian community pharmacies after the introduction of ulipristal acetate (UPA) and to explore pharmacists' knowledge, decision-making, attitudes and beliefs surrounding supplying EC. STUDY DESIGN: A mixed-methods approach of mystery shopping with structured interview was employed. From August to November 2017, 20 pharmacy students mystery-shopped 10 community pharmacies in metropolitan Sydney, Australia, requesting "the morning after pill...
September 2018: Contraception
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