Медицинский совет (Apr 2020)
Uterine myoma: new and perspective options for medicinal treatment
Abstract
The review provides information on the medical treatment of uterine fibroids (MM) in a comparative aspect. MM are one of the most common gynecological diseases requiring surgical intervention in the presence of symptoms. As a drug treatment, gestagens and their combinations with estrogens, which did not demonstrate reliable efficacy, were the first to be proposed. Later, obvious advantages of using GnRH agonists/antagonists that cause the effect of “central” chemical castration were discovered, and therefore their use is limited to 6 months, and they are successfully used to prepare patients for surgery. Recently, non-peptide orally active GnRH receptor antagonists have been proposed that are in the early stages of clinical trials. However, changes in the dosage form and route of administration of drugs that inhibit the activity of GRH do not improve their safety profile. Another breakthrough in MM therapy has been the use of selective progesterone receptor modulators, previously called “antiprogestins.” The drugs of this group have comparable efficacy and better tolerance to AGnRH, which makes the possible long-term treatment of uterine fibroids, especially in premenopausal women, using these drugs.
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