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Relation between hormonal therapy and tibolone with SERMs in postmenopausal women's myomes growth Ginecol Obstet Mex. 2008 Oct;76(10):610-4 Myomas (both leiomyomas and fibromas) are the most frequent benign uterine tumors in women, they can be found in 77% of hysterectomy specimens. There are reports that previous hormonal therapy (estrogen-progestin), more than five (5) years, is associated with high risk (fourfold higher) of leiomyomas. A study in patients without myomas demonstrated this type tumors production (5%) after receiving transdermical-oral hormonal combination during 24 months, and they were absent in patients with only oral therapy. Hormonal therapy increases size and quantity of myomas, or has a neutral effect. This therapy looks like having a higher effect in myoma growth. Tibolone has a neutral effect in myoma volume, and typical doses of raloxifene have no influence in its growth. If postmenopausal women with myomas need some therapy to control symptoms, hormonal therapy is not the best option; however, in asymptomatic patients tibolone is more suitable and raloxifene can be prescribed. PubMedTibolone reverses the cognitive effects caused by leuprolide acetate administration, improving mood and quality of life in patients with symptomatic uterine leiomyomas. Palomba S, Orio F Jr, Falbo A, Oppedisano R, Tolino A, Zullo F. Department of Obstetrics and Gynecology, University "Magna Graecia" of Catanzaro, Catanzaro, Italy. Fertil Steril. 2008 Jul;90(1):165-73. Epub 2007 Nov 14. "OBJECTIVE: To investigate the effects of tibolone co-administration with GnRH agonist treatment in terms of cognition, mood, and quality of life. DESIGN: Randomized, controlled, single-blind, clinical trial. SETTING: Department of gynecology and obstetrics at a university in Italy. PATIENT(S): One hundred ten premenopausal women with symptomatic uterine leiomyomas. INTERVENTION(S): Six months of treatment with leuprolide acetate depot (11.25 mg IM, every 3 mo) associated with either tibolone (2.5 mg/d orally; group A) or placebo (1 tablet per d; group B). MAIN OUTCOME MEASURE(S): At baseline and after 6 months of treatment, uterine and leiomyoma sizes, leiomyoma-related symptoms, climacteric-like symptoms, cognition, mood, and quality of life. RESULT(S): At study entry, no difference was detected between groups in any parameters assessed. After treatment, the leiomyoma-related symptoms were significantly reduced in both groups, without any statistically significant differences between them. The Kupperman Index was statistically significantly higher in group B in comparison with baseline and group A. The cognition scores were statistically significantly different in comparison with baseline in group B, whereas no change was observed in group A. After treatment, mood and quality of life were statistically significantly improved in both groups, even though the improvement was significantly higher in group A than in group B. CONCLUSION(S): Tibolone administration reverses the deleterious effect on cognition that is caused by leuprolide acetate depot and improves mood and quality of life in patients who receive GnRH agonist for symptomatic uterine leiomyomas." PubMed
New
anti-hormone drug shrinks uterus tumors NEW YORK (Reuters Health) - Treatment with CDB-2914, a drug that blocks the effects of the hormone progesterone, can markedly reduce the size of uterine fibroids tumors, benign growths that can cause bleeding and affect fertility, new research shows. Dr. Lynnette K. Nieman, from the National Institutes of Health in Bethesda, Maryland, and colleagues believe that CDB-2914 may be safer than other medical treatments for fibroids because the anti-hormone effect is relatively specific. Their trial, which is reported in the journal Obstetrics & Gynecology, included 18 women ages 33 to 50 with at least one fibroid greater than 2 centimeters in diameter. Six patients each were randomly assigned to CDB-2914, at 10- or 20-milligram doses daily, or to an inactive "placebo," for three cycles, or 90 to 102 days if no menstrual period occurred. Magnetic resonance imaging revealed that the fibroids shrunk by up to 36 percent with CDB-2914 treatment. By contrast, fibroids grew, by 6 percent on average,with placebo. CDB-2914 users also showed improvements in their fibroid symptoms, the report indicates. Just one patient experienced a menstrual bleeding during treatment with CDB-2914. Estrogen levels were reduced in the CDB-2914 group, but they were not low enough to cause problems, such as thinning of the bones, the authors note. "This small study suggests that CDB-2914 holds promise for the treatment of uterine (fibroids)," Nieman and her associates conclude. "Further investigation is needed to establish whether longer therapy provides additional (fibroid) reduction and whether a lower dose might be effective." SOURCE: Obstetrics & Gynecology, May 2008. www.nlm.nih.gov/medlineplus/news/fullstory_64042.html CDB-2914 for Uterine Leiomyomata Treatment: A Randomized Controlled Trial. Levens ED, Potlog-Nahari C, Armstrong AY, Wesley R, Premkumar A, Blithe DL, Blocker W, Nieman LK. Obstet Gynecol. 2008 May;111(5):1129-1136 PubMed
Firstly how long after Zoladex has stopped releasing can an UAE be performed. Secondly, is a MRI necessary prior to the UAE?
Zoladex (like it's cousin
Lupron, which is used in
the U.S.A.) works in part by narrowing the Uterine Artery and it's
branches. I generally wait until after Lupron has had a chance to
wear off (at least 4 weeks after the expected duration of effects) so that
the effect on those vessels is reversed. If the vessels are narrowed
by the medication it increases the technical difficulty or the procedure,
as well as the risk of both complications and technical failure (such as
being unable to get into one vessel or not being able to deliver enough
particles).
Anastrozole, Tamoxifen, and Bone Loss on the ATAC Trial - Cancer.gov
Proellex: Double-blind, placebo-controlled Phase 1/2 study for the treatment of Uterine Fibroids - Interim Assessment (Repros) Repros’ Lead Product Proellex to Enter Phase 3 for the Treatment of Uterine Fibroid Indications 12/3/07Effects of the selective progesterone receptor modulator asoprisnil on uterine artery blood flow, ovarian activity, and clinical symptoms in patients with uterine leiomyomata scheduled for hysterectomy. Wilkens J, Chwalisz K, Han C, Walker J, Cameron IT, Ingamells S, Lawrence A, Lumsden MA, Hapangama D, Williams AR, Critchley HO. J Clin Endocrinol Metab. 2008 Sep 2. "Introduction: Asoprisnil, a novel orally active selective progesterone receptor modulator (SPRM), is being studied for the management of symptomatic uterine leiomyomata. The exact mechanism of action is not yet discerned. The primary objectives of this double-blind randomised placebo-controlled study included evaluation of the effect of asoprisnil on uterine artery blood flow. Further, we assessed effects of asoprisnil on leiomyoma symptoms. Patients and methods: 33 premenopausal patients scheduled for hysterectomy due to symptomatic uterine leiomyomata were recruited in four centres and treated with asoprisnil 25mg, 10mg or placebo for 12 weeks prior to surgery. At baseline and prior to hysterectomy, all patients underwent sonographic assessment to measure impedance to uterine artery blood flow, determined by resistance index (RI) and pulsatility index (PI), as well as volumes of largest leiomyoma and uterus. In addition, patients recorded intensity and frequency of menstrual bleeding on a menstrual pictogram (MP). Each asoprisnil treatment was compared to placebo. Results: The increased PI in both asoprisnil groups and the statistically significantly increased RI within the asoprisnil 25mg group suggest a moderately decreased uterine artery blood flow. Analysis of MP scores showed a statistically significant larger decrease in frequency and intensity of bleeding for both asoprisnil groups compared to placebo. Bleeding was suppressed by asoprisnil 25mg in 91% of patients. Asoprisnil treatment was well tolerated when administered daily for a 12-week period, and no serious adverse events occurred. Conclusion: Asoprisnil moderately reduced uterine artery blood flow. This effect may contribute in part to the clinical effects of asoprisnil." PubMed Selective progesterone receptor modulator asoprisnil down-regulates collagen synthesis in cultured human uterine leiomyoma cells through up-regulating extracellular matrix metalloproteinase inducer. Morikawa A, Ohara N, Xu Q, Nakabayashi K, Demanno DA, Chwalisz K, Yoshida S, Maruo T.Hum Reprod. 2008 Feb 15"BACKGROUND A recent clinical trial demonstrated that selective progesterone receptor modulator asoprisnil is effective in reducing uterine leiomyoma volume. We investigated the effects of asoprisnil in vitro on the expression of the extracellular matrix (ECM)-remodeling enzymes and collagens in cultured leiomyoma and matching normal myometrial cells." PubMed Comparative effects of SPRM Asoprisnil (J867) on proliferation, apoptosis, and the expression of growth factors in cultured uterine leiomyoma cells and normal myometrial cells. Reprod Sci. 2007 Dec;14 PubMed Study of Asoprisnil in the Treatment of Uterine Fibroids. This study has been completed.
Goserelin versus
Leuprolide before hysterectomy for uterine fibroids.
Lim SS,
Sockalingam JK,
Tan PC.
Int J Gynaecol Obstet. 2007 Dec 27
PubMed
Effects of
Letrozole on proliferation and
apoptosis in cultured leiomyoma cells treated with prostaglandin E(2).
Han M,
Kim JY,
Park JE,
Kim JM,
Lee KS.
Eur J Obstet Gynecol Reprod Biol.
2007 Dec 28
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