Photo Credit: YURY PRONIN

The following is a summary of “A study on the efficacy and safety of long-term adjusted low-dose gonadotropin-releasing hormone agonist therapy for uterine fibroids and adenomyosis,” published in the October 2024 issue of Obstetrics and Gynecology by Kashiwabara et al.    

In women, uterine fibroids (UF) and adenomyosis (AM) are prevalent conditions that cause significant menstrual symptoms.  

Researchers conducted a retrospective study to assess the efficacy and safety of long-term adjusted low-dose gonadotropin-releasing hormone (GnRH) agonist therapy concerning effectiveness and safety.  

They included 118 patients with UF and/or AM receiving GnRH agonist (nafarelin acetate) therapy for at least 7 months (2010-2020) and evaluated blood hemoglobin levels, maximum fibroid diameter, area of the corpus uteri, blood estradiol levels, regular dosage of nafarelin acetate, and bone density in the lumbar spine and femoral neck.  

The results showed menstruation ceased in all patients, with median hemoglobin levels increasing from 8.6 to 13.2 g/dL for UF and 8.8 to 13.3 g/dL for AM at 12 months. No significant reduction in fibroid or AM size, and no patient experienced an increase in size. The initial nafarelin acetate dose of 400 μg/day was reduced to 130 μg/day by 12 months, with only 29 patients (25%) having estradiol levels below 30 pg/mL. Average bone density changes over 6 months were −1.23% in the lumbar spine and −1.12% in the femoral neck for patients with UF, while patients with AM experienced changes of −1.06% in the lumbar spine −0.14% in the femoral neck and −1.06% in the lumbar spine, which was lower than previously reported rates.  

They concluded that GnRH agonist therapy was an effective long-term treatment option for patients with UF and AM, demonstrating minimal AEs.  

Source: obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.16128