Management of symptomatic uterine fibroids after ulipristal acetate suspension and identification of high risk patients for surgery at 6-months of follow-up

Abstract

Objective

The use of ulipristal acetate (UPA) was indicated for the treatment of uterine fibroids. Following UPA suspension in March 2020, some patients presented worsening and required surgery. We aimed to identify patients at high-risk for undergoing surgery after UPA suspension.

Methods

We evaluated 85 women receiving intermittent UPA treatment until March 2020. Following UPA suspension, patients received other medical treatments or surgery. The clinico-pathological features were recoded and a quality of life health survey was completed by patients at the time of UPA suspension and at 6-months thereafter.

Results

After the suspension of UPA, 17 of the 85 patients receiving intermittent UPA (20%) required surgery, and 68 (80%) required other medical treatments. Patients who underwent surgery were younger and had greater fibroid volume.

Conclusions

In our series, 20% of clinically stable patients receiving intermittent UPA required surgery following UPA suspension. These women should be considered for future medical strategies.

症状性子宫肌瘤在醋酸乌利司他停药后的管理以及6个月随访中高风险患者的识别 摘要

目的：醋酸乌利司他(UPA)用于治疗子宫肌瘤。随访在2020年3月UPA停药后, 一些患者出现恶化且需要手术。我们的目的是识别UPA停药后行手术的高危患者。

方法：我们评估了85例在2020年3月前接受UPA间断治疗的女性。在中止UPA治疗后, 患者接受其他药物治疗或者手术。记录临床-病理特征, 在停止UPA治疗时及停药后6个月由患者完成生活质量健康调查。

结果：UPA停药后, 85例间断UPA的患者中有17例（20%）要求手术, 68例（80%）要求其他药物治疗。手术的患者更年轻, 子宫肌瘤的体积更大。

结论：在我们研究中, 20%的临床稳定患者需要在UPA停用后进行手术。这些女性应考虑未来的医疗策略。

Keywords:

• Uterine fibroids
• ulipristal acetate
• surgery
• EMA cancelation
• SPRM

Acknowledgements

We thank Donna Pringle for English revision.

Disclosure statement

The authors report no conflict of interest.