Human Reproduction, Vol 12, 2028-2035, Copyright © 1997 by Oxford University Press
D Gonzalez-Barcena, RB Alvarez, EP Ochoa, IC Cornejo, AM Comaru-Schally, AV Schally, J Engel, T Reissmann and H Riethmuller-Winzen
The efficacy of the luteinizing hormone-releasing hormone antagonist
Cetrorelix (SB-75) in the medical management of uterine leiomyomas
(fibromas) was evaluated. Cetrorelix was administered to 18 pre- menopausal
women with myomas with a mean age of 33.3 years, who had been candidates
for hysterectomy. The initial dose of Cetrorelix was 5 mg twice daily s.c.
for the first 2 days and thereafter 0.8 mg was given twice daily s.c. for
at least 3 months. The mean duration of the treatment was 4.4 months.
Before the therapy with Cetrorelix, the mean uterine volume, measured by
ultrasonography, was 395.4 +/- 69.2 ml (range 89-1166). Sixteen patients
showed a progressive reduction in uterine volume from 410.4 +/- 77.1 to a
mean of 230.8 +/- 52.6 ml at 3 months. All patients became amenorrhoeic and
had hot flushes. After treatment with Cetrorelix, a surgical myomectomy was
performed in 12 women. One of the patients subjected to myomectomy after
therapy with Cetrorelix became pregnant. These patients have been followed
for up to 25 months and only in one case has the uterine volume increased
after therapy. Three patients had good responses to therapy with Cetrorelix
and it was decided to follow them only by observation. One patient became
pregnant 2 months later. In the other patient, the uterine volume remained
unchanged for the duration of the follow-up of 2 years and the third
patient showed an increase after 21 months. In three patients, it was
necessary to perform total hysterectomy. In 14 patients, serum
concentrations of luteinizing hormone, follicle stimulating hormone and
oestradiol decreased after the administration of the first dose of
Cetrorelix and continued at subnormal values throughout therapy. In 15
patients who were not subjected to total hysterectomy, menstrual function
returned at 1 month after cessation of treatment. Overall results support
the use of Cetrorelix for the management of uterine leiomyomas.
ARTICLES
Treatment of uterine leiomyomas with luteinizing hormone-releasing hormone antagonist Cetrorelix
The Hospital de Especialidades Centro Medico La Raza - IMSS, Mexico.
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