Dutch investigators assessed maximal volume reduction of leiomyomas and uterus and the duration of treatment required to reach these reductions with daily GnRH antagonist treatment.

Leiomyomas are benign soft-tissue neoplasms that arise from smooth muscle.
Uterine leiomyoma ( fibroids ) are the most common gynecologic neoplasm in women of reproductive age.
As the number one cause of hysterectomy, they have a profound negative impact on women’s health.
Uterine leiomyoma are hormonally dependent and as such are a potential target for endocrine active compounds.

Twenty premenopausal women with symptomatic fibroids, who were scheduled for surgery, were treated with daily 2 mg of subcutaneous Ganirelix ( Antagon ).

One woman was excluded from the study due to incorrect administration dose of Ganirelix.

Data on the remaining 19 women ( average age 39 years ) with subserosal ( n= 9 ), submucosal ( n= 7 ), intramural ( n= 10 ) and transmural ( n= 1 ) leiomyomas were evaluated.

Baseline leiomyoma volumes ranged from small ( 34 mL ) to large ( >1000 mL ).

The median duration of treatment up to maximal leiomyoma size reduction was 19 days ( range 165 days ).

The maximal size reduction in leiomyomas measured by ultrasound scans ( USS ) was 42.7% and 29.2% by MRI ( magnetic resonance imaging ) .

Comparable uterine size reductions of 46.6% and 25.2% were observed by USS and MRI.

During the first three weeks of treatment, 42.1% of the women reported adverse events related to the induced hypoestrogenic state.
Most of these events resolved within one week after treatment was discontinued.

This study showed that daily treatment with 2 mg of Ganirelix results in rapid reduction of leiomyoma and uterine volume in premenopausal women with minor side effects.

If longer-acting GnRH antagonists become available, pretreatment with GnRH antagonist should be preferred over GnRH agonists prior to surgery, according to authors.

Source: BJOG, 2005


XagenaMedicine2005