Prospective Study on Low-Dose Mifepristone for the Treatment of Leiomyoma: A Hospital Based Study

Abstract

Background: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Medical Management of fibroid uterus can be done by Mifepristone, a progesterone antagonist. This study was commenced to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months. In addition, any symptomatic improvement of menorrhagia and dysmenorrhea was also studied. Materials & Methods: The study was designed as an observational prospective study done on women diagnosed with uterine fibroids attending OPD of Dept. of Obstetrics & Gynaecology, Pataliputra Medical College, Jharkhand. A total of 48 patients were enrolled in the study. Out pf 48, only 36 patients completed our study.  50 mg of mifepristone weekly used, and patient assessed at 1 and 6 month. They were a follow up period of 3 months after stopping the drug to observe the changes in menstrual pattern, fibroid volume, hemoglobin and liver function tests. Results: Majority of the study population comprised of perimenopausal women, i.e., 36–45 years (48 %). Fifty percent of the patients were Para 2 and belonged to the perimenopausal age-group (18 out of 36). The dominant presenting symptom was menorrhagia associated with dysmenorrhea and pelvic pain. After 6 months of treatment with mifepristone, the mean fibroid volume reduced from 204.33 to 113.16 cm3 (n = 33), and the percentage mean volume reduction of the fibroid in the study population was 44.57 %. Immediate reduction in bleeding PV was observed in 100 %, and 88.89 % (32/36) patients attained amenorrhea. The mean hemoglobin increased from 9.18 to 10.82 g/dl. Conclusion: To conclude, 6 months therapy with 50 mg of mifepristone given weekly is efficacious and acceptable for the treatment of symptomatic leiomyoma, especially in a select group of patients.