TREATMENT OF UTERINE LEIOMYOMAS WITH LUTEINIZING-HORMONE-RELEASING HORMONE ANTAGONIST CETRORELIX

The efficacy of the luteinizing hormone-releasing hormone antagonist C etrorelix (SB-75) in the medical management of uterine leiomyomas (fib romas) was evaluated, Cetrorelix was administered to 18 pre-menopausal women with myomas with a mean age of 33.3 years, who had been candida tes for hysterectomy, The initial dose of Cetrorelix was 5 mg twice da ily s.c. for the first 2 days and thereafter 0.8 mg was given twice da ily s.c. for at least 3 months, The mean duration of the treatment was 4.4 months, Before the therapy with Cetrorelix, the mean uterine volu me, measured by ultrasonography, was 395.4 +/- 69.2 ml (range 89-1166) , Sixteen patients showed a progressive reduction in uterine volume fr om 410.4 +/- 77.1 to a mean of 230.8 +/- 52.6 ml at 3 months, All pati ents became amenorrhoeic and had hot flushes, After treatment with Cet rorelix, a surgical myomectomy was performed in 12 women, One of the p atients subjected to myomectomy after therapy with Cetrorelix became p regnant, These patients have been followed for up to 25 months and onl y in one case has the uterine volume increased after therapy, Three pa tients had good responses to therapy with Cetrorelix and it was decide d to follow them only by observation. One patient became pregnant 2 mo nths later, In the other patient, the uterine volume remained unchange d for the duration of the follow-up of 2 years and the third patient s howed an increase after 21 months, In three patients, it was necessary to perform total hysterectomy, In 14 patients, serum concentrations o f luteinizing hormone, follicle stimulating hormone and oestradiol dec reased after the administration of the first dose of Cetrorelix and co ntinued at subnormal values throughout therapy, In 15 patients who wer e not subjected to total hysterectomy, menstrual function returned at 1 month after cessation of treatment, Overall results support the use of Cetrorelix for the management of uterine leiomyomas.