COMBINED RELUGOLIX TREATMENT FOR HIGHLY SYMPTOMATIC UTERINE LEIOMYOMA PATIENTS
DOI:
https://doi.org/10.22551/b70h9t28Keywords:
LEIOMYOMA, MENOMETRORRAHAGIA, SEVERE ANEMIA, RELUGOLIXAbstract
Many conservative treatments for symptomatic uterine leiomyoma have been proposed but in the large majority of cases these are often limited by the associated side effects. A relative novel treatment with GnRH antagonists has been reported in the literature with good results. The primary goal was to assess the degree of reduction of uterine global volume and largest uterine fibroma volume at the end of 24 weeks of combined treatment with Relugolix 40 mg, 1 mg estradiol and 0.5 mg norethindrone acetate as well as at 12 weeks after. The secondary goal was to subjectively assess the reduction of vaginal bleeding during treatment and the evolution of hematologic parameters. Materials and methods: We analyzed 5 patients with uterine leiomyoma with heavy menometrorrhagia and severe anemia. 4 cases rejected the surgical treatment and 1 case was not suitable for surgery due to morbid obesity and associated pathology. All cases accepted the combined therapy with relugolix 40 mg, 1 mg estradiol and 0.5 mg norethindrone acetate for a period of 24 weeks. Results: In all cases, the reduction of uterine and largest leiomyoma volume was consistent after 24 weeks of treatment and maintained so even 12 weeks after. In addition, the severity of vaginal bleeding was also reduced, so that the hematologic parameters slowly improved. Conclusions: Combined therapy with relugolix 40 mg, 1 mg estradiol and 0.5 mg norethindrone acetate is a very good alternative especially in cases where surgery is not accepted or is not suitable due to associated morbidity.
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