Effectiveness of Mifepristone in the Treatment of Uterine Leiomyoma

Aim: The present study was carried out to evaluate efficacy of 3 months of oral mifepristone in decreasing the severity of symptoms and in decreasing uterine and fibroid volume.

Methods: This was a prospective study conducted at prathima institute of medical sciences in Obstetrics and Gynaecologt department, karimnagar, Telangana Fifty symptomatic patients with fibroids received 25 mg of mifepristone daily for 3 months and baseline data regarding Hb value, PBAC score (pictorial blood loss assessment chart), VAS (visual analogue scale), Uterine volume and Fibroid volume were compared with those recorded at the end of 1st month, 3rd month and 3 months after stoppage of mifepristone.

Results: Treatment with Mifepristone significantly reduced mean PBAC score to 95% after 1 month, 98% after 3 months and 58% compared to the pre-treatment value. Mean VAS score was reduced to 67% after 1 month, 72% after 3 months and 47% after 3 months of stoppage of drug to pre-treatment value. Mean uterine volume was reduced 24% after 1 month, 44% after 3 months and 35% in post treatment follow up patients compared to pre-treatment value. Mean baseline fibroid volume was reduced to 25% after 1 month, 54% after 3 months and 40% in post treatment follow up patients. Though all these parameters slightly raised after stopping mifepristone, significantly reduced compared to baseline values. Haemoglobin was raised by 2.12 gm/Dl from baseline at the end of 3rd month of therapy but slightly decreased compared to values of 3rd month treatment. Baseline endometrium was 7.4 mm which was increased to 8.24 mm after 3 months of treatment, it has come down to the baseline value which shows that endometrial thickness during treatment was transient. 12% of patients became amenorrhoeic after treatment but menstruation was resumed in 32.78% patients in post treatment follow up patients. There were minimal side effects during the course of study.

Conclusion: Low dose oral Mifepristone 25 mg for 3 months significantly reduced Menorrhagia, backache, dysmenorrhoea and other associated symptoms, decreased uterine and fibroid volume and improved Haemoglobin levels with minimal side effects.