Ulipristal acetate use in adenomyosis: A randomized controlled trial

Objective: To evaluate the effect of a 10 mg per day 12 week treatment of ulipristal acetate (UPA) on abnormal uterine bleeding due to adenomyosis. Design: A double-blind phase 2 randomized controlled pilot study.Setting: From May 2015 to February 2018 in five teaching hospitals. Population: Premenopausal women with abnormal uterine bleeding (with a pictorial blood loss assessment score (PBAC) higher than 100 at inclusion) and a sonographic or MRI diagnosis of adenomyosis. Methods: After random allocation, either UPA 10 mg or placebo were orally administered during 12 weeks. A 3:1 ratio was used. Main outcome measures: The primary outcome was the rate of women with a PBAC score of less than 75 as evaluated over the 28 days following the 12-week treatment. Secondary outcomes included rate of amenorrhea, evolution of pain, quality of life and tolerance. Results: Thirty women were included in the UPA group and 10 in the placebo group. No woman in the placebo group versus 95.24 % of women in the UPA group had a PBAC score under 75 during the 28 day period following the 12-week treatment (p < 0.01). A significant decrease in pain was noticed between inclusion and 13 weeks in the UPA group (p < 0.01). At 6 months, there was no significant difference in PBAC score or pain between groups. No serious adverse event was recorded. Conclusion: UPA could be an interesting option for treatment of abnormal uterine bleeding related to adenomyosis in women wishing to preserve their fertility. (C) 2020 Elsevier Masson SAS. All rights reserved.

Automated summary

This study evaluated the effect of UPA on abnormal uterine bleeding due to adenomyosis, showing a significantly higher rate of women with PBAC score under 75 in the UPA group compared to the placebo group after 28 days of treatment, along with a significant reduction in pain for the UPA group. At 6 months, there was no significant difference in outcomes between the two groups, indicating that UPA could be a potential option for treating this condition.