scholarly journals Safety and efficacy of two repeated cycles of ulipristal acetate in the management of symptomatic uterine fibroid among Indian women

2021 ◽  
Author(s):  
Sangam Jha ◽  
Naaz Ahmed ◽  
Hemali Heidi Sinha
Keyword(s):  
Uterine Fibroid ◽  
Indian Women ◽  
Safety And Efficacy ◽  
Ulipristal Acetate ◽  
Symptomatic Uterine Fibroid

scholarly journals The Selective Progesterone Receptor Modulator Ulipristal Acetate Inhibits the Activity of the Glucocorticoid Receptor

2019 ◽  
Vol 105 (3) ◽  
pp. 716-734 ◽  
Author(s):  
Benjamin Small ◽  
Charles E F Millard ◽  
Edwina P Kisanga ◽  
Andreanna Burman ◽  
Anika Anam ◽  
...  
Keyword(s):  
Glucocorticoid Receptor ◽  
Uterine Fibroid ◽  
Target Genes ◽  
Nuclear Translocation ◽  
Ex Vivo ◽  
Therapeutic Option ◽  
The Body ◽  
Dependent Manner ◽  
Ulipristal Acetate

Abstract Context The selective progesterone modulator ulipristal acetate (ulipristal) offers a much-needed therapeutic option for the clinical management of uterine fibroids. Although ulipristal initially passed safety evaluations in Europe, postmarketing analysis identified cases of hepatic injury and failure, leading to restrictions on the long-term use of ulipristal. One of the factors potentially contributing to significant side effects with the selective progesterone modulators is cross-reactivity with other steroid receptors. Objective To determine whether ulipristal can alter the activity of the endogenous glucocorticoid receptor (GR) in relevant cell types. Design Immortalized human uterine fibroid cells (UtLM) and hepatocytes (HepG2) were treated with the synthetic glucocorticoid dexamethasone and/or ulipristal. Primary uterine fibroid tissue was isolated from patients undergoing elective gynecological surgery and treated ex vivo with dexamethasone and/or ulipristal. In vivo ulipristal exposure was performed in C57Bl/6 mice to measure the effect on basal gene expression in target tissues throughout the body. Results Dexamethasone induced the expression of established glucocorticoid-target genes period 1 (PER1), FK506 binding protein 51 (FKBP5), and glucocorticoid-induced leucine zipper (GILZ) in UtLM and HepG2 cells, whereas cotreatment with ulipristal blocked the transcriptional response to glucocorticoids in a dose-dependent manner. Ulipristal inhibited glucocorticoid-mediated phosphorylation, nuclear translocation, and DNA interactions of GR. Glucocorticoid stimulation of PER1, FKBP5, and GILZ was abolished by cotreatment with ulipristal in primary uterine fibroid tissue. The expression of glucocorticoid-responsive genes was decreased in the lung, liver, and uterus of mice exposed to 2 mg/kg ulipristal. Interestingly, transcript levels of Fkbp5 and Gilz were increased in the hippocampus and pituitary. Conclusions These studies demonstrate that ulipristal inhibits endogenous glucocorticoid signaling in human fibroid and liver cells, which is an important consideration for its use as a long-term therapeutic agent.

scholarly journals Intra-arterial embolisation of uterine fibroma

2009 ◽  
Vol 56 (4) ◽  
pp. 209-213
Author(s):  
M.Z. Mijailovic ◽  
S.M. Lukic
Keyword(s):  
Prospective Study ◽  
Uterine Fibroid ◽  
Benign Tumors ◽  
Pelvic Cavity ◽  
Mild Form ◽  
Arterial Embolisation ◽  
One Year ◽  
A Prospective Study ◽  
Leading Symptom ◽  
Symptomatic Uterine Fibroid

Uterine fibroid are benign tumors that consist most of the tumor occurrences in pelvic cavity of women. Possible courses of treatment include: medicament treatment, surgical and new intra-arterial embolisation method. The aim of the paper is to present achieved results in intra-arterial embolisation treatment of Uterine fibroid. Material and methods: A prospective study was performed in the period from October 2007 until October 2008. It included 36 women with symptomatic uterine fibroid. They were treated by intra-arterial embolisation. All patients had control MRI examinations after treatment. Embolisation was performed by 'cross-over' technique, using bilateral punction of femoral arteries, a selective catheterization a. uterine, and application of 750-900m Bead Blocks. Results: Average age of patients was 38.5 years. The most of fibroids had intramural localization (39%). solitary fibroids were seen in 56% of patients, multiple in 44%. Gynecological hemorrhage was the leading symptom with 34 patients (94%). One year after receiving intra-arterial embolisation treatment, fibroid regression of 50% was registered in all patients. There were no serious complications noted in our study, with the exception of postembolisation syndrome which occurred in 11 (30%) patients in a relatively mild form Conclusion: Intra-arterial embolisation of uterine fibroma is a method that in large percent of patients removes symptoms of uterine fibroma presence, prevents its growth, and safely helps women enter menopause when activity of hormone dependant tumor ceases.

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