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 asmost of the patients are asymptomatic but most commonclinical feature which makes women seek their treatment aremenorrhagia and iron deficiency anaemia leading to chronicfatigue. Study aimed to compare the efficacy of UPA andmifepristone in medical management of uterine fibroids insymptomatic patients of reproductive age group.Material and methods: A prospective randomizedobservational study was carried out, in women with single ormultiple uterine leiomyoma. Exclusion criteria severe anemia,using any hormonal therapy, with suspected carcinomas orwith adnexal masses. 100 patients were randomly allocatedto two subgroups; group A receiving 5 mg UPA and groupB receiving 25 mg Mifepristone daily, for 13 weeks. PBACwas used to assess menstrual blood loss and Likert scorefor other symptoms. Baseline variables uterine size andvolume, Myoma size and volume, number, hemoglobin, liverfunction tests were noted and reassessed at 1, 3 and 6 months.Endometrial sampling was done initially and at the end tostudy.Results: Mean fibroid volume reduction was 35.23% in groupA and 33.45% after 13 weeks’ treatment in group B. Meanreduction in menorrhagia 84% in group A and 52.5% in groupB. 91% cases experienced amenorrhoea in group A and 72%in group B.Conclusion: UPA 5mg was better at achieving significantreduction in menorrhagia and achieving amenorrhoeic state ascompared to Mifepristone.