Efficacy and Safety of Mifepristone as a Non-Surgical Treatment of Uterine Leiomyomas/Fibroids

Uterine leiomyomas, or fibroids, are common benign gynecological tumors that affect many women during their reproductive years. Although surgical removal has traditionally been the primary treatment, pharmacological management––particularly with progesterone receptor modulators like mifepristone (RU 486)––is gaining interest due to its potential to reduce the need for surgery. However, there is limited research on the effectiveness of mifepristone for this purpose. 

The goal of a recent study was to evaluate the safety and efficacy of mifepristone in reducing the size of uterine leiomyomas and alleviating the associated symptoms.

This prospective study included 20 pre-menopausal women aged 18 years or older from Nanavati Max Super Speciality Hospital in Mumbai, India. Participants were selected based on specific criteria, including the presence of at least one uterine myoma with a minimum diameter of 2.5 cm – confirmed by ultrasound. The average age of participants was 39.75 years, and the average BMI was 27.58 kg/m².

The results revealed that mifepristone significantly reduced uterine volume by 75%, with hemoglobin levels improving from an initial 9 gm/dL to 12.51 gm/dL after six months. Pain intensity, measured using the Visual Analog Scale (VAS), showed a gradual decrease from baseline to three months, with all 20 patients reporting a complete absence of pelvic pain by six months.

Thus, the results demonstrated that mifepristone is a promising non-surgical treatment for effectively reducing uterine fibroid volume, improving hemoglobin levels, and mitigating uterine blood loss in patients.

Source: Desai S, Oswal S, Patel C, et al. The Journal of Obstetrics and Gynecology of India. 2024 Feb 14:1-6.