A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status
Received 13 May 2008; received in revised form 16 September 2008; accepted 19 September 2008. published online 09 January 2009.
Objective
To examine and compare the efficacy and safety of GnRH agonist (GnRHa) vs. aromatase inhibitor in premenopausal women with leiomyomas.
A total of 70 subjects with a single uterine myoma measuring ≥5 cm. Subjects were randomized into two groups with use of a random table. They were treated with aromatase inhibitor (group A) or GnRHa (group B).
Intervention(s)
Group A received letrozole (2.5 mg/d) for 12 weeks. Group B received triptorelin (3.75 mg/mo) for 12 weeks.
Main Outcome Measure(s)
Measurement of myoma volume and E2, FSH, LH, and T levels.
Result(s)
Total myoma volume decreased by 45.6% in group A and 33.2% in group B. Reductions in myoma volume in the two groups were statistically significant. There was no significant change in hormonal milieu in group A. The serum level of hormones significantly decreased in group B by the 12th week of treatment.
Conclusion(s)
Uterine myoma volume was successfully reduced by use of an aromatase inhibitor. Rapid onset of action and avoidance of initial gonadotropin flare with an aromatase inhibitor may be advantageous for short-term management of women with myomas of any size who are to be managed transiently and who wish to avoid surgical intervention, specifically women with unexplained infertility having uterine myoma.
aDepartment of Gynecology and Obstetrics, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
bDepartment of Statistical Sciences, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
cGynecologic Endoscopy Division, Diako Teaching Center of Göttingen University, Bremen, Germany
Reprint requests: Mohammad Ebrahim Parsanezhad, M.D., Division of Infertility and Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, P.O. Box 71345-1657, Shiraz, Iran (FAX: 98-711-229-6486).
M.E.P. has nothing to disclose. M.A. has nothing to disclose. S.A. has nothing to disclose. A.R. has nothing to disclose. A.Z. has nothing to disclose. T.K. has nothing to disclose. V.F. has nothing to disclose. E.H.S. has nothing to disclose.
ABSTRACT