Department of Obstetrics & Gynaecology, St. George's Hospital and University of London, Cranmer Terrace, Tooting, London SW17 0RE, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2012 Dec;165(2):135-40. doi: 10.1016/j.ejogrb.2012.07.023. Epub 2012 Aug 15.
The majority of symptomatic uterine fibroids are currently treated by surgical interventions (myomectomy or hysterectomy) or radiological treatments (uterine artery embolisation or focussed ultrasound surgery). None of these treatments is a panacea, and what is conspicuous is the lack of an effective long-term medical therapy for a disorder so common among women of reproductive age. It has been known for some time that progesterone and its receptors enhance proliferative activity in fibroids and this has raised the possibility that anti-progestins and (PRMs) could be useful in the medical management of fibroids. Some of the compounds which have produced promising results in recent clinical trials or research studies include mifepristone, CDB-4124 (telapristone), CP-8947, J-867 (asoprisnil) and CDB-2914 (ulipristal acetate or UA). UA has recently completed Phase III clinical trials with very encouraging results, and has now acquired a licence for clinical use in Europe. While considerable research has yet to be done on the long-term safety and efficacy of UA there is nevertheless good reason for optimism on the emergence of effective medical therapy in the form of UA and possibly other PRMs.
目前，大多数有症状的子宫肌瘤是通过手术干预（子宫肌瘤切除术或子宫切除术）或放射治疗（子宫动脉栓塞术或聚焦超声手术）来治疗的。这些治疗方法都不是万无一失的，明显缺乏针对这种在育龄妇女中如此常见的疾病的有效长期药物治疗方法。众所周知，孕激素及其受体可增强子宫肌瘤的增殖活性，这使得抗孕激素药物（PRM）在子宫肌瘤的药物治疗中可能有用。在最近的临床试验或研究中取得了有希望结果的一些化合物包括米非司酮、CDB-4124（telapristone）、CP-8947、J-867（asoprisnil）和 CDB-2914（醋酸乌利司他或 UA）。UA 最近完成了 III 期临床试验，结果非常令人鼓舞，现已在欧洲获得临床使用许可。虽然还有大量关于 UA 的长期安全性和有效性的研究尚未完成，但 UA 以及其他可能的 PRM 作为有效的药物治疗方法的出现仍然有充分的理由让人感到乐观。
