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一项关于新型选择性孕激素受体调节剂阿索普瑞尼治疗子宫肌瘤女性的随机对照试验。

A randomized, controlled trial of asoprisnil, a novel selective progesterone receptor modulator, in women with uterine leiomyomata.

作者信息

Chwalisz Kristof, Larsen Lois, Mattia-Goldberg Cynthia, Edmonds Anthony, Elger Walter, Winkel Craig A

机构信息

TAP Pharmaceutical Products Inc., Lake Forest, Illinois 60045, USA.

出版信息

Fertil Steril. 2007 Jun;87(6):1399-412. doi: 10.1016/j.fertnstert.2006.11.094. Epub 2007 Feb 20.

DOI:10.1016/j.fertnstert.2006.11.094
PMID:17307170
Abstract

OBJECTIVE

To determine efficacy and safety of asoprisnil in patients with leiomyomata.

DESIGN

Phase 2, multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-group study.

SETTING

Twenty-eight sites in the United States and 1 in Canada.

PATIENT(S): One hundred twenty-nine women with leiomyomata.

INTERVENTION(S): Asoprisnil (5, 10, or 25 mg) or placebo orally daily for 12 weeks.

MAIN OUTCOME MEASURE(S): Uterine bleeding changes by using daily bleeding diaries, hemoglobin concentrations, dominant leiomyoma and uterus volume measured sonographically, patient-reported symptoms related to bloating and pelvic pressure, endometrial thickness and morphology, hormonal parameters, and standard safety measures.

RESULT(S): Asoprisnil suppressed uterine bleeding in 28%, 64%, and 83% of subjects at 5, 10, and 25 mg, respectively, and reduced leiomyoma and uterine volumes. Median percentage decrease from baseline in leiomyoma volume was statistically significant at 25 mg compared with placebo after 4 and 8 weeks of treatment; by week 12, leiomyoma volume was reduced by 36%. There was a significant reduction in bloating with the two highest doses and in pelvic pressure with 25 mg by week 12. Asoprisnil was associated with follicular-phase estrogen concentration and minimal hypoestrogenic symptoms.

CONCLUSION(S): After 12-week treatment, asoprisnil controlled uterine bleeding while reducing leiomyoma volume and the associated pressure symptoms. Asoprisnil was well tolerated.

摘要

目的

确定阿索普瑞尔治疗平滑肌瘤患者的疗效和安全性。

设计

2期、多中心、前瞻性、随机、双盲、安慰剂对照、平行组研究。

地点

美国28个地点和加拿大1个地点。

患者

129名平滑肌瘤女性。

干预措施

阿索普瑞尔(5、10或25毫克)或安慰剂,每日口服,共12周。

主要观察指标

通过每日出血日记记录子宫出血变化、血红蛋白浓度、超声测量优势平滑肌瘤和子宫体积、患者报告的与腹胀和盆腔压迫相关的症状、子宫内膜厚度和形态、激素参数以及标准安全指标。

结果

阿索普瑞尔分别使5毫克、10毫克和25毫克剂量组中28%、64%和83%的受试者子宫出血得到抑制,并减小了平滑肌瘤和子宫体积。治疗4周和8周后,与安慰剂相比,25毫克剂量组平滑肌瘤体积从基线下降的中位数百分比具有统计学意义;到第12周,平滑肌瘤体积减少了36%。到第12周,两个最高剂量组的腹胀和25毫克剂量组的盆腔压迫均显著减轻。阿索普瑞尔与卵泡期雌激素浓度相关,且低雌激素症状轻微。

结论

经过12周治疗,阿索普瑞尔在控制子宫出血的同时减小了平滑肌瘤体积及相关压迫症状。阿索普瑞尔耐受性良好。

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