Ulipristal Acetate Therapy versus Uterine Artery Embolization in Management of Uterine Fibroids A Randomized Controlled Trial

Abstract

Study objective: To prove that Ulipristal acetate is an effective line of management for uterine fibroids by causing a significant decline in fibroid volumes resulting in a substantial relief of fi-broid-related symptoms, and to compare its results with those of uterine artery embolization. Design: A randomized control trial. Setting: Maternity Hospital, Ain Shams University and Mount Sinai Hospital, University of Toronto. Patients: Women with symptomatic uterine fibroids. Interventions: 70 women were randomly assigned to either Ulipristal Acetate (UA) group or uterine artery embolization (UAE) group (35 in each group). Both groups were followed up to detect the decline in fibroid size as well as the improvement of symptoms. Measurements and Main Results: Ulipristal acetate (UA) showed a statistically significant decline in dominant fibroid volume and diameter at 3 months (37.5% and 36% respectively) and a durable effect at 6 months (34.2% and 30% respectively) compared to a 35.4% and 36% decline at 3 months and 32% and 30.7% decline in dominant fibroid volume and diameter respec-tively at 6 months for uterine artery embolization (UAE). More-over, there was a statistically significant improvement in fibroid-associated symptoms among both study groups but with a higher durability at 6 months among the patients of the UA group. Conclusion: Our study showed that a 3-month course of Ulipristal acetate (UA) is very effective in the management of symptomatic uterine fibroids and its results are comparable to uterine artery embolization (UAE),, by causing a significant de-cline in uterine fibroid volumes resulting in the resolution of fi-broid-associated symptoms. Moreover, Ulipristal acetate (UA)’s action is more durable, up to 6 months after initiating therapy.