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子宫肌瘤的当前和新兴治疗选择。

Current and Emerging Treatment Options for Uterine Fibroids.

机构信息

Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL, 60637, USA.

Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt.

出版信息

Drugs. 2023 Dec;83(18):1649-1675. doi: 10.1007/s40265-023-01958-6. Epub 2023 Nov 3.

Abstract

Uterine fibroids are the most common benign neoplasm of the female reproductive tract in reproductive age women. Their prevalence is age dependent and can be detected in up to 80% of women by the age of 50 years. Patients affected by uterine fibroids may experience a significant physical, emotional, social, and financial toll as well as losses in their quality of life. Unfortunately, curative hysterectomy abolishes future pregnancy potential, while uterine-sparing surgical and radiologic alternatives are variously associated with reduced long-term reproductive function and/or high tumor recurrence rates. Recently, pharmacological treatment against uterine fibroids have been widely considered by patients to limit uterine fibroid-associated symptoms such as heavy menstrual bleeding. This hormonal therapy seemed effective through blocking the stimulatory effects of gonadal steroid hormones on uterine fibroid growth. However, they are contraindicated in women actively pursuing pregnancy and otherwise effective only during use, which is limited because of long-term safety and other concerns. Accordingly, there is an urgent unmet need for safe, durable, and fertility-compatible non-surgical treatment options for uterine fibroids. In this review article, we cover the current pharmacological treatments for uterine fibroids including their comparable efficacy and side effects as well as emerging safe natural compounds with promising anti-uterine fibroid effects.

摘要

子宫肌瘤是育龄期妇女生殖系统最常见的良性肿瘤。其患病率与年龄相关,在 50 岁时,多达 80%的女性可检测到子宫肌瘤。受子宫肌瘤影响的患者可能会经历显著的身体、情感、社会和经济负担,以及生活质量的下降。不幸的是,根治性子宫切除术会消除未来的妊娠潜力,而保留子宫的手术和放射学替代方法则与降低长期生殖功能和/或高肿瘤复发率有关。最近,药物治疗子宫肌瘤已被患者广泛考虑,以限制子宫肌瘤相关症状,如月经过多。这种激素疗法似乎通过阻断性腺类固醇激素对子宫肌瘤生长的刺激作用而有效。然而,它们在积极寻求妊娠的女性中被禁用,而且仅在使用期间有效,由于长期安全性和其他问题,使用受到限制。因此,对于子宫肌瘤患者来说,迫切需要安全、持久和生育兼容的非手术治疗选择。在这篇综述文章中,我们涵盖了子宫肌瘤的当前药物治疗方法,包括它们的疗效和副作用的比较,以及具有有希望的抗子宫肌瘤作用的新兴安全天然化合物。

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