Efficacy and tolerability of CDB-2914 treatment for symptomatic uterine fibroids: a randomized, double-blind,
Lynnette K Nieman1, Wendy Blocker, Tonja Nansel
1Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA. NiemanL@nih.gov
Objective:
To evaluate the efficacy and tolerability of the P receptor modulator CDB-2914 (Ulipristal, CDB).
Design:
Randomized, placebo-controlled double-blind clinical trial.
Setting:
Clinical research center.
Patient(S):
Premenopausal women with symptomatic uterine fibroids.
Intervention(S):
Once-daily oral CDB (10 or 20 mg) or placebo (PLC) for 12 weeks (treatment 1). A second 3-month treatment with CDB (treatment 2) was offered. A computer-generated blocked randomization was used.
Main Outcome Measure(S):
Magnetic resonance imaging (MRI)-determined total fibroid volume (TFV) change was the primary outcome; amenorrhea and quality of life (QOL) were secondary end points.
Result(S):
Treatment 1 TFV increased 7% in the PLC group, but decreased 17% and 24% in the CDB10 and CDB20 groups. The TFV decreased further in treatment 2 (-11%). Amenorrhea occurred in 20/26 women taking CDB and none on PLC. Ovulation resumed after CDB. Hemoglobin improved only with CDB (11.9 ± 1.5 to 12.9 ± 1.0 g/dL) as did the Fibroid QOL Questionnaire symptom severity, energy/mood, and concern subscores, and overall QOL scores. The CDB was well tolerated, with no serious adverse events. Adverse events were unchanged during treatments.
Conclusion(S):
Administration of CDB-2914 for 3-6 months controls bleeding, reduces fibroid size, and improves QOL.
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