To Compare the Efficacy of Ulipristal acetate and Mifepristone in Management of Uterine Fibroids in Symptomatic Patients of Reproductive Age Group

Abstract

Introduction: Uterine myomas incidence is variable as most of the patients are asymptomatic but most common clinical feature which makes women seek their treatment are menorrhagia and iron deficiency anaemia leading to chronic fatigue. Study aimed to compare the efficacy of UPA and mifepristone in medical management of uterine fibroids in symptomatic patients of reproductive age group. Material and methods: A prospective randomized observational study was carried out, in women with single or multiple uterine leiomyoma. Exclusion criteria: severe anemia, using any hormonal therapy, with suspected carcinomas or with adnexal masses. 100 patients were randomly allocated to two subgroups; group A receiving 5 mg UPA and group B receiving 25 mg Mifepristone daily, for 13 weeks. PBAC was used to assess menstrual blood loss and Likert score for other symptoms. Baseline variables: uterine size and volume, Myoma size and volume, number, hemoglobin, liver function tests were noted and reassessed at 1, 3 and 6 months. Endometrial sampling was done initially and at the end to study. Results: Mean fibroid volume reduction was 35.23% in group A and 33.45% after 13 weeks’ treatment in group B. Mean reduction in menorrhagia: 84% in group A and 52.5% in group B. 91% cases experienced amenorrhoea in group A and 72% in group B. Conclusion: UPA 5mg was better at achieving significant reduction in menorrhagia and achieving amenorrhoeic state as compared to Mifepristone.