Title: Current approaches to overcome the side effects of GnRH analogs in the treatment of patients with uterine fibroids.
Authors: Ali, Mohamed; Raslan, Mohamed; Ciebiera, Michał; Zaręba, Kornelia; Al-Hendy, Ayman
Published In Expert Opin Drug Saf, (2022 Apr)
Abstract: INTRODUCTION: Uterine fibroids (UFs) are the most prevalent benign neoplastic threat originating from myometria of reproductive age women, with a profound financial load valued in hundreds of billions of dollars. Unfortunately, there is no curative treatment so far except surgery and available pharmacological treatments are restricted for short-term treatment options. Thus, there is a large unmet need in the UF space for noninvasive therapeutics. AREAS COVERED: The authors reviewed the literature available for the utility of gonadotropin-releasing hormone (GnRH) analogs in women with UFs. We also focused on clinical studies exploring the therapeutic benefits of novel oral non-peptide GnRH antagonists that were recently approved by the U.S. Food and Drug Administration (FDA) in combination with estradiol/norethindrone acetate for the management of heavy menstrual bleeding associated with UFs in premenopausal women. EXPERT OPINION: The results regarding the efficacy of new-generation oral GnRH-antagonists, such as elagolix, relugolix and linzagolix, are promising and offer potential prospect for the future therapy of UFs. However, these antagonists must be combined with hormonal add-back therapy to minimize the resultant hypoestrogenic side effects such as bone loss.
PubMed ID: 34612122
MeSH Terms: Carboxylic Acids/therapeutic use; Female; Gonadotropin-Releasing Hormone/analogs & derivatives*; Humans; Leiomyoma*/drug therapy; Pyrimidines; Uterine Neoplasms*/drug therapy