An Evidence-based Approach to the Medical Management of Fibroids: A Systematic Review

Chantal B Bartels; Kamaria C Cayton; Farah S Chuong; Kristine Holthouser; Sara E Arian; Tara Abraham; James H Segars

doi:10.1097/GRF.0000000000000171

An Evidence-based Approach to the Medical Management of Fibroids: A Systematic Review

Clin Obstet Gynecol. 2016 Mar;59(1):30-52. doi: 10.1097/GRF.0000000000000171.

Authors

Chantal B Bartels¹, Kamaria C Cayton, Farah S Chuong, Kristine Holthouser, Sara E Arian, Tara Abraham, James H Segars

Affiliation

¹ *Department of Obstetrics and Gynecology University of Connecticut School of Medicine, Farmington, Connecticut †Department of Gynecology and Obstetrics, Howard W and Georgeanna Seegar Jones Division of Reproductive Sciences and Women's Health Research, Johns Hopkins University School of Medicine, Baltimore, Maryland ‡Department of Obstetrics, Gynecology and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky §Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio ∥Foxhall OB/GYN Associates, Washington, District of Columbia.

PMID: 26756261
DOI: 10.1097/GRF.0000000000000171

Abstract

Fibroids are the most common tumor of the female reproductive tract, but approved medical treatments are limited. Patients demand uterine-sparing treatments which preserve fertility and avoid surgery. We systematically reviewed PubMed and Cochrane databases from January 1985 to November 2015 for evidence-based medical therapies for fibroids in the context of disease prevention, treatment of early disease, treatment of symptomatic disease, and preoperative management. We identified 2182 studies, of which 52 studies met inclusion and exclusion criteria. Published data affirm the efficacy of multiple agents, which are promising avenues for the development of medical alternatives to surgery.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Androgens / therapeutic use*
Aromatase Inhibitors / therapeutic use*
Contraceptive Agents, Female / therapeutic use*
Contraceptives, Oral, Combined / therapeutic use
Curcumin
Delayed-Action Preparations
Drugs, Chinese Herbal / therapeutic use
Estradiol / analogs & derivatives
Estradiol / therapeutic use
Estrenes / therapeutic use
Estrogen Receptor Antagonists / therapeutic use
Evidence-Based Medicine
Female
Fulvestrant
Gonadotropin-Releasing Hormone / agonists*
Gonadotropin-Releasing Hormone / antagonists & inhibitors
Hormone Antagonists / therapeutic use*
Humans
Intrauterine Devices, Medicated
Leiomyoma / drug therapy*
Leiomyoma / prevention & control
Levonorgestrel / therapeutic use
Medroxyprogesterone Acetate / therapeutic use
Mifepristone / therapeutic use
Neoadjuvant Therapy
Norpregnadienes / therapeutic use
Oximes / therapeutic use
Plant Extracts / therapeutic use*
Receptors, Progesterone / antagonists & inhibitors
Selective Estrogen Receptor Modulators / therapeutic use
Tea
Uterine Myomectomy
Uterine Neoplasms / drug therapy*
Uterine Neoplasms / prevention & control
Vitamin D / therapeutic use
Vitamins / therapeutic use

Substances

Androgens
Aromatase Inhibitors
Contraceptive Agents, Female
Contraceptives, Oral, Combined
Delayed-Action Preparations
Drugs, Chinese Herbal
Estrenes
Estrogen Receptor Antagonists
Hormone Antagonists
Norpregnadienes
Oximes
Plant Extracts
Receptors, Progesterone
Selective Estrogen Receptor Modulators
Tea
Vitamins
Vitamin D
telapristone acetate
Fulvestrant
Mifepristone
Gonadotropin-Releasing Hormone
Estradiol
Levonorgestrel
asoprisnil
Medroxyprogesterone Acetate
Curcumin
ulipristal acetate