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Wilson LF, Moss KM, Doust J, Farquhar CM, Mishra GD. First Australian estimates of incidence and prevalence of uterine fibroids: a data linkage cohort study 2000-2022. Hum Reprod 2024:deae162. [PMID: 39013145 DOI: 10.1093/humrep/deae162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/23/2024] [Indexed: 07/18/2024] Open
Abstract
STUDY QUESTION What is the estimated prevalence and incidence of uterine fibroids diagnosed in Australian women of reproductive age? SUMMARY ANSWER An estimated 7.3% of Australian women had a diagnosis of uterine fibroids by the age of 45-49 years, with age-specific incidence highest in women aged 40-44 years (5.0 cases per 1000 person-years). WHAT IS KNOWN ALREADY Uterine fibroids are associated with a high symptom burden and may affect overall health and quality of life. Studies in different countries show a wide variation in both the prevalence (4.5-68%) and incidence (2.2-37.5 per 1000 person-years) of uterine fibroids, which may be partly explained by the type of investigation, method of case ascertainment, or the age range of the study population, necessitating the reporting of country-specific estimates. STUDY DESIGN, SIZE, DURATION This observational prospective cohort study using self-report survey and linked administrative data (2000-2022) included 8066 women, born between 1973 and 1978, in the Australian Longitudinal Study on Women's Health. PARTICIPANTS/MATERIALS, SETTING, METHODS A combination of self-report survey and linked administrative health data (hospital, emergency department, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Scheme) were used to identify women with a report of a diagnosis of uterine fibroids between 2000 and 2022. MAIN RESULTS AND THE ROLE OF CHANCE Of the 8066 Australian women followed for 22 years, an estimated 7.3% of women (95% CI 6.9, 7.6) had a diagnosis of uterine fibroids by the age of 45-49 years. The incidence increased with age and was highest in women aged 40-44 years (5.0 cases per 1000 person-years, 95% CI 4.3, 5.7 cases per 1000 person-years). Women with uterine fibroids were more likely to experience heavy or painful periods. They were also more likely to report low iron levels, endometriosis, and poor self-rated health and to have two or more annual visits to their general practitioner. LIMITATIONS, REASONS FOR CAUTION Our estimates are based on self-report of doctor diagnosis or treatment for fibroids and/or data linked to treatment and procedure administrative records. This predominantly captures women with symptomatic fibroids, but has the potential for misclassification of asymptomatic women and an underestimate of overall prevalence and incidence. In addition, questions on fibroids were only asked in surveys when women were 37-42 years of age to 43-48 years of age, so cases at younger ages may have been underestimated (particularly in women with less severe symptoms) as these were only ascertained through data linkage. WIDER IMPLICATIONS OF THE FINDINGS These are the first population-based estimates of the prevalence and incidence of uterine fibroids in women of reproductive age in Australia. Establishing these first estimates will help inform health policy and health care provision in the Australian context. STUDY FUNDING/COMPETING INTEREST(S) The ALSWH is funded by the Australian Government Department of Health and Aged Care. L.FW. was supported by an Australian National Health and Medical Research Council (NHMRC) Centres for Research Excellence grant (APP1153420) and G.D.M. was supported by an NHMRC Leadership Fellowship (APP2009577). The funding bodies played no role in the design, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- L F Wilson
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - K M Moss
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - J Doust
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - C M Farquhar
- Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
| | - G D Mishra
- School of Public Health, The University of Queensland, Herston, QLD, Australia
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Gagnon PL, Thérasse É, Voizard N, Dubé M, Caty V. Uterine Fibroid Embolization Survey in Canada: Challenges, Opportunities, and Differences in Practices Across the Country. Can Assoc Radiol J 2024:8465371241252307. [PMID: 38755969 DOI: 10.1177/08465371241252307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Purpose: To assess the current practices surrounding Uterine Fibroid Embolization (UFE) in Canada. Methods: An online survey was sent to Canadian Association for Interventional Radiology (CAIR) members. It included questions on symptoms prompting UFE, patient awareness, investigation, UFE settings, the number of UFE procedures, and post-UFE care. The findings were discussed at CAIR's 2023 annual meeting by an expert panel. Results: Out of 792 surveys sent, 87 were filled (11%). Menorrhagia is the most common indication for UFE (87%). Women's awareness of UFE as a treatment option for fibroids is viewed as poor or average by 94% of our survey respondents. Most respondents see patients in clinics (92%) before the procedure and evaluate fibroids with MRI pre-UFE (76%). There is variability in care post-UFE, with 33% of procedures being performed as day surgery while 67% lead to overnight stay. For pain management, intravenous analgesia (including patient-controlled analgesia) is used in 76% (63/83) of cases while 19% (16/83) of respondents mentioned using epidural analgesia. Finally, there is an even split between embolic agent used; non-spherical polyvinyl alcohol (50%) and spherical particles (50%). Conclusion: Respondents believe patients in Canada still have limited awareness of UFE. Interventional radiologists are increasingly involved in the entire patient care trajectory, overseeing pre-and post-procedure care and hospitalizing patients. For pain management after UFE, it is observed that while epidural analgesia has been demonstrated more effective than alternatives, it is not widely used as the primary method.
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Affiliation(s)
- Pierre-Luc Gagnon
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Éric Thérasse
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Nicolas Voizard
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Michel Dubé
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Véronique Caty
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
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Vilos GA, Vilos AG, Burbank F. Bipedalism and the dawn of uterine fibroids. Hum Reprod 2024; 39:454-463. [PMID: 38300232 DOI: 10.1093/humrep/deae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 01/03/2024] [Indexed: 02/02/2024] Open
Abstract
The high prevalence and burden of uterine fibroids in women raises questions about the origin of these benign growths. Here, we propose that fibroids should be understood in the context of human evolution, specifically the advent of bipedal locomotion in the hominin lineage. Over the ≥7 million years since our arboreal ancestors left their trees, skeletal adaptations ensued, affecting the pelvis, limbs, hands, and feet. By 3.2 million years ago, our ancestors were fully bipedal. A key evolutionary advantage of bipedalism was the freedom to use hands to carry and prepare food and create and use tools which, in turn, led to further evolutionary changes such as brain enlargement (encephalization), including a dramatic increase in the size of the neocortex. Pelvic realignment resulted in narrowing and transformation of the birth canal from a simple cylinder to a convoluted structure with misaligned pelvic inlet, mid-pelvis, and pelvic outlet planes. Neonatal head circumference has increased, greatly complicating parturition in early and modern humans, up to and including our own species. To overcome the so-called obstetric dilemma provoked by bipedal locomotion and encephalization, various compensatory adaptations have occurred affecting human neonatal development. These include adaptations limiting neonatal size, namely altricial birth (delivery of infants at an early neurodevelopmental stage, relative to other primates) and mid-gestation skeletal growth deceleration. Another key adaptation was hyperplasia of the myometrium, specifically the neomyometrium (the outer two-thirds of the myometrium, corresponding to 90% of the uterine musculature), allowing the uterus to more forcefully push the baby through the pelvis during a lengthy parturition. We propose that this hyperplasia of smooth muscle tissue set the stage for highly prevalent uterine fibroids. These fibroids are therefore a consequence of the obstetric dilemma and, ultimately, of the evolution of bipedalism in our hominin ancestors.
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Affiliation(s)
- George A Vilos
- Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Angelos G Vilos
- Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Fred Burbank
- Salt Creek International Women's Health Foundation, San Clemente, CA, USA
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Koga K, Fukui M, Fujisawa M, Suzukamo Y. Impact of diagnosis and treatment of uterine fibroids on quality of life and labor productivity: The Japanese online survey for uterine fibroids and quality of life (JOYFUL survey). J Obstet Gynaecol Res 2023; 49:2528-2537. [PMID: 37524334 DOI: 10.1111/jog.15758] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/22/2023] [Indexed: 08/02/2023]
Abstract
AIM To investigate the impact of uterine fibroid diagnosis/treatment status on quality of life (QOL) and work productivity in women living in Japan. METHODS Women aged 20-49 years who registered on Macromill were recruited via the opt-in method. They completed an online survey on demographic and uterine fibroid diagnosis/treatment status, 36-Item Short-Form Health Survey, Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire (UFS-QOL), and World Health Organization Health and Work Performance Questionnaire. RESULTS There were 4120 respondents: 1362 untreated, 249 with ongoing treatment, 449 with past treatment, 1030 with no uterine fibroids, and 1030 with unknown uterine fibroid status. A high proportion of women with ongoing treatment had moderate to severe uterine fibroid-like symptoms (symptom severity score of UFS-QOL ≥40 points), accompanied by reduced QOL. QOL was improved in women with past treatment. Uterine fibroids had a significant impact on physical and psychosocial aspects in the ongoing treatment group versus other groups. Using classification and regression tree analysis, anemia was identified as a plausible predictor of reduced QOL in the ongoing treatment group. Approximately 20% of women-even in groups other than the ongoing treatment group-experienced moderate to severe uterine fibroid-like symptoms. However, the diagnosis and treatment status of uterine fibroids had no clear impact on work productivity. CONCLUSIONS Uterine fibroids, especially in association with anemia, were related to reduced QOL. Given that uterine fibroid-related reduced QOL is likely improved by appropriate treatment, women with uterine fibroid-like symptoms, such as menorrhagia, should be examined and treated.
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Affiliation(s)
- Kaori Koga
- Department of Gynecologic Surgery, The University of Tokyo Hospital, Tokyo, Japan
- Department of Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | | | - Yoshimi Suzukamo
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
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Adebamowo CA, Morhason-Bello IO, Adebamowo SN. Validation of self-report of uterine fibroid diagnosis using a transvaginal ultrasound scan. Sci Rep 2023; 13:9091. [PMID: 37277479 DOI: 10.1038/s41598-023-36313-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/31/2023] [Indexed: 06/07/2023] Open
Abstract
Self-report of uterine fibroids (UF) has been used for epidemiologic research in different environments. Given the dearth of studies on the epidemiology of UF in Sub-Saharan Africa (SSA), it is valuable to evaluate its performance as a potential tool for much needed research on this common neoplasm in SSA women. We conducted a cross-sectional study of self-report of UF compared with transvaginal ultrasound diagnosis (TVUS) among 486 women who are members of the African Collaborative Center for Microbiome and Genomics Research (ACCME) Study Cohort in central Nigeria. We used log-binomial regression models to compute the classification, sensitivity, specificity, and predictive values of self-report compared to TVUS, adjusted for significant covariates. The prevalence of UF on TVUS was 45.1% (219/486) compared to 5.4% (26/486) based on self-report of abdominal ultrasound scan and 7.2% (35/486) based on report of healthcare practitioner's diagnosis. Self-report correctly classified 39.5% of the women compared to TVUS in multivariable adjusted models. The multivariable adjusted sensitivity of self-report of healthcare worker diagnosis was 38.8%, specificity was 74.5%, positive predictive value (PPV) was 55.6%, and negative predictive value (NPV) was 59.8%. For self-reported abdominal ultrasound diagnosis, the multivariable adjusted sensitivity was 40.6%, specificity was 75.3%, PPV was 57.4%, and NPV was 60.6%. Self-report significantly underestimates the prevalence of UF and is not accurate enough for epidemiological research on UF. Future studies of UF should use population-based designs and more accurate diagnostic tools such as TVUS.
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Affiliation(s)
- Clement A Adebamowo
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, 660 West Redwood Street, Baltimore, MD, 21201, USA.
- Greenebaum Comprehensive Cancer Center, School of Medicine, University of Maryland, Baltimore, MD, USA.
- Center for Bioethics and Research, Ibadan, Nigeria.
- Institute of Human Virology Nigeria, Abuja, Nigeria.
| | - Imran O Morhason-Bello
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, and the Institute of Advanced Medical Research and Training College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Sally N Adebamowo
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, 660 West Redwood Street, Baltimore, MD, 21201, USA
- Greenebaum Comprehensive Cancer Center, School of Medicine, University of Maryland, Baltimore, MD, USA
- Center for Bioethics and Research, Ibadan, Nigeria
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Xu W, Chen W, Chen J, Hu L, Su X, Nie Y, Shi Q. Adaptability and clinical applicability of UFS-QoL in Chinese women with uterine fibroid. BMC Womens Health 2022; 22:372. [PMID: 36088381 PMCID: PMC9463796 DOI: 10.1186/s12905-022-01963-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To demonstrate the applicability and adaptability of uterine fibroid symptoms and quality of life (UFS-QoL) in assessing the efficacy of treatment in Chinese populations.
Methods
This is a secondary analysis of a prospective cohort study involving 20 Chinese hospitals and 2,411 Chinese women with fibroids. Patients completed UFS-QoL and short form-36 (SF-36) at pre-surgery, 6-month and 12-month post-treatments. Internal consistency of the quality of life assessed by the UFS-QoL questionnaire using Cronbach’s α coefficient (α). Principal axis factor analysis with orthogonal rotation was established to investigate relationships between items and subscales. Concurrent validity refers to the Spearman's correlation estimate of the correlation between UFS-QoL and SF-36. Using effect size and standardized response mean, the ability to detect change was evaluated by comparing pre- and post-6-month and post-12-month treatment scores.
Results
Exploratory factor analysis yielded six subscales (concern, activities, energy/mood, control, self-consciousness, and sexual function) with eigenvalues > 1 in UFS-QoL. A 63.61% total variance was explained by the test items. Ceiling effects of self-consciousness and sexual functioning subscales from UFS-QoL were > 15%. UFS-QoL showed a positive and moderate correlation with SF-36 to establish good concurrent validity. And showed good consistency reliability (Cronbach α > 0.7 in all subscales), ability to detect change after treatment. This excluded self-consciousness (α = 0.56), which demonstrated the lowest effect size (0.38) and standardized response means (0.38) 6- and 12-months post-treatment.
Conclusions
Symptom severity, activity, and mood subscales of the Chinese UFS-QoL were valid and reliable. However, the self-consciousness domain needs further investigation on cultural adaptation, such as cognitive debriefing for how Chinese interpret these questions.
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Zhao W, Zhao Y, Chen L, Sun Y, Fan S. Effects of miRNA-199a-5p on cell proliferation and apoptosis of uterine leiomyoma by targeting MED12. Open Med (Wars) 2022; 17:151-159. [PMID: 35071776 PMCID: PMC8749127 DOI: 10.1515/med-2021-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/aims
Uterine leiomyoma (ULM) is a kind of gene-involved benign tumor, which is located in the front of female reproductive tract. It is one of the most common reproductive tract tumors in women, which leads to abnormal menstruation, repeated pregnancy loss, and other serious gynecological diseases. Recently, microRNAs (miRNAs) have attracted much more attention in the process of exploring the molecular mechanisms of tumorigenesis. Furthermore, the deregulated miRNAs had been reported to play important roles in ULM pathology.
Methods
In this study, we assessed the expression level of microRNA-199a-5p (miR-199a-5p) in human ULM by quantitative polymerase chain reaction. After that cell counting kit 8, colony formation, 5-ethynyl-20-deoxyuridine, flow cytometry, and Western blot analyses were performed to investigate the effects of miR-199a-5p on ULM cell proliferation and apoptosis.
Results
We confirmed that miR-199a-5p was significantly downregulated in human ULM. The results of function analyses showed that miR-199a-5p inhibited cell proliferation and induced cell apoptosis in vitro. Bioinformatics tool showed oncogene MED12 was one of the target genes of miR-199a-5p, which mediated the effect of miR-199a-5p on the ULM.
Conclusion
Our results showed that miR-199a-5p functioned as an antitumor factor in human ULM cells. These findings broaden the current findings on the function of miR-199a-5p into the ULM pathogenesis, and miR-199a-5p may serve as a prognosis and therapeutic target for the ULM and its related diseases.
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Affiliation(s)
- Wei Zhao
- Department of Clinical Laboratory, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital , Nanjing , Jiangsu 210004 , China
| | - Yingyan Zhao
- Department of Obstetrics and Gynecology, Zhangjiagang Hospital of Traditional Chinese Medicine and Affiliated Zhangjiagang Hospital of Nanjing University of Chinese Medicine , Zhangjiagang 215600 , China
| | - Ling Chen
- Department of Obstetrics and Gynecology, Zhangjiagang Hospital of Traditional Chinese Medicine and Affiliated Zhangjiagang Hospital of Nanjing University of Chinese Medicine , Zhangjiagang 215600 , China
| | - Yan Sun
- Department of Obstetrics and Gynecology, Zhangjiagang Hospital of Traditional Chinese Medicine and Affiliated Zhangjiagang Hospital of Nanjing University of Chinese Medicine , Zhangjiagang 215600 , China
| | - Sumei Fan
- Department of Geriatrics, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an , No. 62, Huaihai Road (S.) , Huaian , Jiangsu 223002 , China
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Hsieh CH, Lu YY, Liang SY. The health concerns related to hysterectomy among Taiwanese women with uterine fibroids- a mixed-methods study. Women Health 2021; 61:581-590. [PMID: 34187330 DOI: 10.1080/03630242.2021.1938791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to assess health concerns after hysterectomy from different perspectives among Taiwanese women with uterine fibroids. A mixed-methods was used in this study. In a cross-sectional study, 95 patients completed a structured questionnaire (Health Concern Questionnaire-HCQ). Face-to-face interviews with 5 patients were implemented for the qualitative component from OBS-GYN outpatient departments at two hospitals in Northern Taiwan. Participants who met the following criteria, 20 years of age or older, conscious alert without mental disturbances were recruited to this study. Descriptive statistics were calculated for social demographic variables and HCQ. A content analysis was used to analyze the qualitative data. The mean age was 46.28 of 95 patients. Findings of the present study showed that the most health concerns among patients with UFs after hysterectomy are hysterectomy-related complications, follow by impacts on daily life, body image and female identity, and intimacy and sexual relations. The findings of qualitative interviews supported the above findings. In addition, the information needs of post-operative self-care were identify in this qualitative interviews. The results of this research study could help healthcare professionals to address women's health concerns and provide adequate care for Taiwanese women with uterine fibroids after hysterectomy.
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Affiliation(s)
- Chun-Hsin Hsieh
- Nurse Practitioner, MSN, Department of Nursing, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Yu-Ying Lu
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Efficacy and safety of vilaprisan in women with uterine fibroids: Data from the phase 2b randomized controlled trial ASTEROID 2. Eur J Obstet Gynecol Reprod Biol 2020; 252:7-14. [DOI: 10.1016/j.ejogrb.2020.05.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022]
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Bonine NG, Banks E, Harrington A, Vlahiotis A, Moore-Schiltz L, Gillard P. Contemporary treatment utilization among women diagnosed with symptomatic uterine fibroids in the United States. BMC Womens Health 2020; 20:174. [PMID: 32791970 PMCID: PMC7427077 DOI: 10.1186/s12905-020-01005-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 06/28/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study evaluated treatment patterns among women diagnosed with symptomatic uterine fibroids (UF) in the United States. Data were retrospectively extracted from the IBM Watson Health MarketScan® Commercial Claims and Encounters and Medicaid Multi-State databases. METHODS Women aged 18-64 years with ≥1 medical claim with a UF diagnosis (primary position, or secondary position plus ≥1 associated symptom) from January 2010 to June 2015 (Commercial) and January 2009 to December 2014 (Medicaid) were eligible; the first UF claim during these time periods was designated the index date. Data collected 12 months pre- and 12 and 60 months post-diagnosis included clinical/demographic characteristics, pharmacologic/surgical treatments, and surgical complications. Prevalence (2015) and cumulative incidence (Commercial, 2010-2015; Medicaid, 2009-2015) of symptomatic UF were estimated. RESULTS 225,737 (Commercial) and 19,062 (Medicaid) women had a minimum of 12 months post-index continuous enrollment and were eligible for study. Symptomatic UF prevalence and cumulative incidence were: 0.57, 1.23% (Commercial) and 0.46, 0.64% (Medicaid). Initial treatments within 12 months post-diagnosis were surgical (Commercial, 36.7%; Medicaid, 28.7%), pharmacologic (31.7%; 53.0%), or none (31.6%; 18.3%). Pharmacologic treatments were most commonly non-steroidal anti-inflammatory drugs and oral contraceptives; hysterectomy was the most common surgical treatment. Of procedures of abdominal hysterectomy, abdominal myomectomy, uterine artery embolization, and ablation in the first 12 months post-index, 14.9% (Commercial) and 24.9% (Medicaid) resulted in a treatment-associated complication. Abdominal hysterectomy had the highest complication rates (Commercial, 18.5%; Medicaid, 31.0%). CONCLUSIONS Off-label use of pharmacologic therapies and hysterectomy for treatment of symptomatic UF suggests a need for indicated non-invasive treatments for symptomatic UF.
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Affiliation(s)
- Nicole Gidaya Bonine
- Health Economics & Outcomes Research - Canada, Allergan plc, 500 - 85 Enterprise Blvd, Markham, ON, L6G 0B5, Canada.
| | - Erika Banks
- Montefiore Medical Center, Bronx, New York, USA
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Strand T, Kives S, Leyland N, Ashkenas J, Janiszewski P, Thiel J. Treatment Choices in a National Cohort of Canadian Women With Symptomatic Uterine Fibroids. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:1475-1482.e2. [PMID: 33046429 DOI: 10.1016/j.jogc.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe treatment choices made at the time of enrollment in CAPTURE, a Canadian patient registry for women with symptomatic uterine fibroids (UFs), and to define demographic and clinical characteristics that independently predict these choices. METHODS Women arranging appointments for UF care were eligible to enrol. At the time of the enrollment visit, women's self-reported treatment histories were noted, along with their clinical characteristics. Tretment options were discussed and chosen during that visit. Patients could choose medical and/or surgical treatment, or they could opt for no active treatment (i.e., "watchful waiting"); treatment decisions were not binding. RESULTS The most common medication proposed and chosen was ulipristal acetate (UPA), and the most common procedure was myomectomy. These treatments were also the most commonly identified in patients' histories. Medication alone and medication in combination with surgery were the most common treatment approaches chosen (46% and 26%, respectively). Surgery alone and watchful waiting were chosen by 14% and 13% of patients, respectively. Significant predictors of active treatment included patient pregnancy plans, overall symptom severity, and prior treatment history (medical and surgical). Other parameters, including patient age and history of specific UF symptoms, appear to influence the choice of medical therapies (UPA, gonadotropin-releasing hormone agonists, or other options) and procedures (myomectomy or hysterectomy). CONCLUSIONS This real-world study documents the patient factors associated with the treatment decisions of women seeking care for symptomatic UFs in contemporary Canadian gynaecology practice. Subsequent analyses will follow the outcomes of these treatments over two years in this population.
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Affiliation(s)
- Tim Strand
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Sari Kives
- Section of Gynecology, St. Michaels Hospital and Hospital for Sick Children and University of Toronto, Toronto, ON
| | - Nicholas Leyland
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | | | | | - John Thiel
- Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, SK.
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Wallace K, Zhang S, Thomas L, Stewart EA, Nicholson WK, Wegienka GR, Wise LA, Laughlin-Tommaso SK, Diamond MP, Marsh EE, Jacoby VL, Anchan RM, Venable S, Larry GM, Lytle B, Wang T, Myers ER. Comparative effectiveness of hysterectomy versus myomectomy on one-year health-related quality of life in women with uterine fibroids. Fertil Steril 2020; 113:618-626. [DOI: 10.1016/j.fertnstert.2019.10.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 10/24/2022]
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Lukes AS, Soper D, Harrington A, Sniukiene V, Mo Y, Gillard P, Shulman L. Health-Related Quality of Life With Ulipristal Acetate for Treatment of Uterine Leiomyomas: A Randomized Controlled Trial. Obstet Gynecol 2020; 133:869-878. [PMID: 30969201 PMCID: PMC6485305 DOI: 10.1097/aog.0000000000003211] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Ulipristal acetate is associated with significant improvements in health-related quality of life and symptom severity compared with placebo in women with symptomatic uterine leiomyomas. OBJECTIVE: To investigate effects of ulipristal acetate on health-related quality of life (QOL) and symptom severity in women with symptomatic uterine leiomyomas and abnormal uterine bleeding. METHODS: Women were randomized to ulipristal (5 mg, 10 mg) or placebo in two phase 3, multicenter, double-blind, placebo-controlled trials (VENUS I and II). Health-related QOL and symptom severity were assessed at baseline, and over one (VENUS I and II) and two (VENUS II) 12-week treatment courses using the Uterine Fibroid Symptom Health-Related Quality of Life questionnaire. In pooled VENUS I and II data, change from baseline to the end of the first course for each Uterine Fibroid Symptom Health-Related Quality of Life scale was analyzed, including a Revised Activities subscale that measured physical and social activities. The proportion of women achieving meaningful change in the Symptom Severity (20 or more points), Health-Related QOL Total (20 or more points), and Revised Activities (30 or more points) scales was calculated. In VENUS II data, change from baseline to the end of each course in each scale was analyzed for each treatment arm. RESULTS: In pooled analyses, the intent-to-treat population included 589 patients (placebo, n=169; ulipristal 5 mg, n=215; ulipristal 10 mg, n=205). Significantly greater improvements from baseline in all Uterine Fibroid Symptom Health-Related Quality of Life scales were observed with both ulipristal doses compared with placebo (P<.001). A meaningful change in Revised Activities was achieved by 51 patients receiving placebo (34.9%), compared with 144 (73.5%; OR 5.0 [97.5% CI 2.9–8.6]) and 141 (80.6%; OR 7.9 [97.5% CI 4.3–14.6]) patients receiving ulipristal 5 mg, and 10 mg, respectively. In VENUS II, at end of courses 1 and 2, both ulipristal doses demonstrated significant improvements from baseline compared with placebo for all Uterine Fibroid Symptom Health-Related Quality of Life scales (P<.01). Mean Revised Activities scores showed that beneficial ulipristal effects were maintained in course 2, and improvements occurred on switching to ulipristal; results for other scales were similar. CONCLUSION: Ulipristal was associated with significant improvements in health-related QOL and symptom severity compared with placebo for women with symptomatic uterine leiomyomas. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02147197 and NCT02147158. FUNDING SOURCE: Allergan plc, Dublin, Ireland.
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Affiliation(s)
- Andrea S Lukes
- Carolina Women's Research and Wellness Center, Durham, North Carolina; Medical University of South Carolina, Charleston, South Carolina; Allergan plc, Irvine, California; Allergan plc, Madison, New Jersey; and the Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Qin H, Lin Z, Vásquez E, Xu L. The association between chronic psychological stress and uterine fibroids risk: A meta-analysis of observational studies. Stress Health 2019; 35:585-594. [PMID: 31452302 DOI: 10.1002/smi.2895] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/07/2019] [Accepted: 08/16/2019] [Indexed: 01/10/2023]
Abstract
The association between chronic psychological stress and uterine fibroids (UFs) risk remains unclear. In this study, a meta-analysis of observational studies was performed to explore the reported association between them. A literature search was performed in PubMed, EMBASE, and Web of Science to identify relevant published articles. A random-effect model was used to examine pooled odds ratio (OR) and 95% confidence interval (CI). Additionally, subgroup analyses and two-stage random-effect dose-response meta-analysis were performed. A total of six articles with seven studies were included in this meta-analysis. For the highest versus lowest category of chronic psychological stress, the pooled OR was 1.24 (95% CI [1.15, 1.34]; p = .000). Through subgroup analyses, we found a positive association between chronic psychological stress and UFs risk especially in non-Hispanic Blacks studies (OR, 1.24, 95% CI [1.14, 1.34], p = .000). When evaluating for a dose-response, we found a weak correlation between chronic psychological stress and UFs risk, especially for the severe (OR, 1.17, 95% CI [1.07, 1.29]) and very severe (OR, 1.23, 95% CI [1.07, 1.41]) categories. Our meta-analysis shows a statistically significant association between chronic psychological stress and UFs risk particularly for non-Hispanic Blacks. Interventions aiming to reduce chronic psychological stress may be useful to decrease the prevalence of UFs.
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Affiliation(s)
- Hao Qin
- School of Basic Medicine, Qingdao University, Qingdao, China.,School of Public Health & Management, Weifang Medical University, Weifang, China
| | - Zhijuan Lin
- Department of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Elizabeth Vásquez
- School of Public Health, University at Albany, State University of New York, New York
| | - Luo Xu
- School of Basic Medicine, Qingdao University, Qingdao, China
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Patient-reported outcome measures in benign gynecologic surgery: updates and selected tools. Curr Opin Obstet Gynecol 2019; 31:259-266. [PMID: 30973376 DOI: 10.1097/gco.0000000000000544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Use of patient-reported outcome measures in clinical practice and research is becoming more prevalent and reflects initiatives to center the patient in healthcare delivery and outcomes assessment. The purpose of this review is to provide a summary description of selected, validated tools used to assess outcomes related to several benign gynecologic conditions: abnormal uterine bleeding, fibroids and endometriosis. RECENT FINDINGS Given the availability of several validated instruments to assess patient outcomes in benign gynecology, there is still significant heterogeneity in tools used in trials. SUMMARY Patient outcomes assessment should be an integral part of clinical practice and research in order to treat the whole patient and address any health-related impacts on quality of life. More attention is needed to increase standardization of tools used in research to facilitate assessment of comparative efficacy between treatments.
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Marsh EE, Al-Hendy A, Kappus D, Galitsky A, Stewart EA, Kerolous M. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt) 2018; 27:1359-1367. [PMID: 30230950 DOI: 10.1089/jwh.2018.7076] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Most women will experience uterine fibroids by the age of 50, yet few data exist describing the overall patient experience with fibroids. The objective of this population-based survey was to characterize symptom burden, patient awareness, and treatment decision-making for fibroids, including a comparison among women of varying backgrounds. MATERIALS AND METHODS Women (≥18 years) were recruited via email from GfK KnowledgePanel®, a representative panel of US households, or identified with opt-in consumer panels. The Uterine Fibroid Symptom and Health-Related Quality of Life (UFS-QOL) questionnaire and Aberdeen Menorrhagia Severity Scale (AMSS) were included. RESULTS Eligible women were grouped into three cohorts: "at-risk" (symptoms suggestive of fibroids without clinical diagnosis, n = 300), "diagnosed" (n = 871), and fibroid-related "hysterectomy" (n = 272). Cohort and intracohort race/ethnicity and income analyses revealed differences in symptom burden, awareness/perception, and treatment history. Based on UFS-QOL scores, at-risk women reported significantly greater symptom severity and decreased health-related QOL versus diagnosed women; Hispanic women reported greater symptom severity versus white and black women. At-risk women also reported heavy menstrual bleeding and significant impact on work productivity. Among diagnosed women, 71% used pharmacologic therapy for symptom relief, and 30% underwent surgical or procedural treatment. Initial discussions with healthcare providers significantly impacted treatment outcomes; the hysterectomy cohort was most likely to first discuss hysterectomy. CONCLUSIONS Women with fibroids or symptoms suggestive of fibroids experience significant distress that reduces QOL, particularly racial minorities and women in lower income brackets. Survey results suggest that many women are likely undiagnosed, underscoring the need for improved awareness and education.
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Affiliation(s)
- Erica E Marsh
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan
| | - Ayman Al-Hendy
- 2 Department of Obstetrics and Gynecology, University of Illinois at Chicago , Chicago, Illinois
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Hervé F, Katty A, Isabelle Q, Céline S. Impact of uterine fibroids on quality of life: a national cross-sectional survey. Eur J Obstet Gynecol Reprod Biol 2018; 229:32-37. [PMID: 30099225 DOI: 10.1016/j.ejogrb.2018.07.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study clinical impact of symptomatic uterine fibroids on women's health-related perceived quality of life regarding several dimensions. STUDY DESIGN A prospective cross-sectional web-based survey was conducted from August 18th to September 2nd 2016 among the general French population of women. A total of 1287 French women over the age of 18, among which 302 reported symptomatic uterine fibroids were surveyed. Data concerning demographics, symptoms and health-related quality of life (HRQL) using the UFS-QoL questionnaire, an overall well-being score and overall discomfort score were collected. RESULTS Almost two thirds of surveyed women (n = 193; 64%) reported moderate to severe fibroid-related symptoms (symptom severity score between 40 and 100). The global HRQL score showed that 64% of women (n = 193) reported a moderate to very important impact of fibroids on quality of life (HRQL global score between 0 and 50). The worse HRQL scores were reported for concern (57.5 ± 26.7), energy (58.1 ± 23.2) and self-conscious subscales (63.4 ± 24.3). The mean overall well-being score was lower in women with symptomatic uterine fibroids (6.6 ± 1.7) than in women without (7.3 ± 1.5). The mean overall discomfort score rated by women with symptomatic uterine fibroid was 5.7 ± 2.5 with a score between 6 and 10 reported by 56% of them. CONCLUSIONS We observed that 64% of surveyed women reported a moderate to very important impact of fibroids on their quality of life. This perceived alteration of quality of life together with the severity of symptomatic fibroids have a significant impact on the overall level of discomfort perceived by women and on their personal quality of life.
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Affiliation(s)
- Fernandez Hervé
- Department of Obstetrics and Gynaecology, Bicêtre Hospital, Kremlin-Bicêtre, France.
| | - Ardaens Katty
- Department of Gynaecology, Residence Paul Eluard Medical Centre, Seclin, France
| | - Queval Isabelle
- INS HEA - Paris Lumières University, EA 7287 GRHAPES, Suresnes, France
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Hasselrot K, Lindeberg M, Konings P, Kopp Kallner H. Investigating the loss of work productivity due to symptomatic leiomyoma. PLoS One 2018; 13:e0197958. [PMID: 29889874 PMCID: PMC5995435 DOI: 10.1371/journal.pone.0197958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/13/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Leiomyoma affects up to 50% of fertile women, leading to morbidity such as bleeding or pain. The effect of symptomatic leiomyoma on the productivity of employed women is understudied. The present study investigates productivity loss in a Swedish setting in women with symptomatic leiomyoma compared to healthy women. Material and methods Women seeking care for leiomyoma and heavy menstrual bleeding (HMB) were recruited at nine Swedish sites. Healthy controls with self-perceived mild to normal menstruation were recruited at routine visits. Cases and controls were employed without option to work from home. After recruitment, all women reported the work productivity and activity impairment (WPAI) questionnaire, the pictorial blood assessment chart (PBAC) and pain on the visual analog scale (VAS). Results Women with symptomatic leiomyoma (n = 88) missed more working time during menses compared to asymptomatic controls (n = 34): 7.6 vs 0.2% p = 0.003. The proportion of impairment while working was also significantly higher in women with symptomatic leiomyoma (43.8 vs 12.1% p<0.001). Moreover, cases reported greater activity impairment outside office hours (43.9 vs 12.1%, p<0.001). Among healthy controls, 69.5% reported symptoms of HMB (PBAC>100). Conclusions Symptomatic leiomyoma leads to loss of working hours as well as loss of productivity during working hours, and affects women in other daily activities. Increased awareness of the impact of leiomyomas on women's lives is needed, and timely and appropriate management of the symptomatic leiomyomas could improve work productivity and quality of life.
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Affiliation(s)
- Klara Hasselrot
- Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden
- Department of Clinical Sciences at Danderyd Hospital, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden
- * E-mail:
| | | | | | - Helena Kopp Kallner
- Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden
- Department of Clinical Sciences at Danderyd Hospital, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden
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Fortin C, Flyckt R, Falcone T. Alternatives to hysterectomy: The burden of fibroids and the quality of life. Best Pract Res Clin Obstet Gynaecol 2017; 46:31-42. [PMID: 29157931 DOI: 10.1016/j.bpobgyn.2017.10.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/06/2017] [Indexed: 01/21/2023]
Abstract
Uterine fibroids are the most common benign tumor in reproductive-aged women. While the majority of women are asymptomatic, those with symptoms may suffer from abnormal uterine bleeding, infertility, pelvic pain or pressure, and urinary dysfunction. Fibroids represent a significant healthcare burden for women and society as a whole. Women with fibroids have compromised overall quality of life and impairment in many specific domains including work productivity, sexuality, self-image, relationships, and social emotional and physical well-being. Many women are reluctant to ask for help and delay seeking treatment. To date, myomectomy remains the gold standard for treating fibroid-related symptoms in reproductive-aged women. However, many less invasive uterine preserving approaches have been developed. Quality of life is improved in many women following treatment for fibroids. This article aims to provide an overview of the substantial impact of fibroids on health-related quality of life.
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Affiliation(s)
- Chelsea Fortin
- Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Rebecca Flyckt
- Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tommaso Falcone
- Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
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Chiumente M, De Rosa M, Messori A, Proli EM. Burden of uterine fibroids in Italy: epidemiology, treatment outcomes, and consumption of health care resources in more than 5,000 women. CLINICOECONOMICS AND OUTCOMES RESEARCH 2017; 9:525-535. [PMID: 28919793 PMCID: PMC5587088 DOI: 10.2147/ceor.s139335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and purpose Epidemiological studies on uterine fibroids (UFs) are mostly based on surveys or analyses of small samples of patients. In 50% of women, the quality of life is worsened by disease-related symptoms; furthermore, treatments imply a remarkable health care cost. The aim of this observational study was to analyze a large sample of Italian patients with UFs and to assess the epidemiology, the appropriateness of treatments, and the consumption of disease-related resources. Methods Data were collected through a data-linkage technique from five administrative databases. Women aged between 18 and 55 years and resident in three local health authorities (north–central–south Italy) were selected over the period from 1st January 2009 to 31st December 2015. The inclusion criteria were a surgical procedure with diagnosis of UFs or a pharmacological treatment with gonadotropin-releasing hormone (GnRH) analogs or ulipristal acetate. Besides the overall descriptive analysis, two comparisons were evaluated: surgery versus no surgery and treatment with GnRH analogs versus ulipristal acetate. Results A total of 5,665 women with UFs were selected from an overall population of 2,400,000 people. In the north, 73.6% of patients underwent surgery, as opposed to only 16.7% in the south; 70% of surgeries were hysterectomies. The average cost per patient was €3,249 (duration of follow-up = up to 7 years). The southern district had the highest number of drug prescriptions; in particular, 49% of patients took >10 packages of GnRH analogs. Conclusion This study is the first on this topic conducted in Italy using a large sample size. The analysis of resource consumption revealed a high heterogeneity in the choice of drug treatments by gynecologists (especially in the south); in the north, marked variations were seen in the rates of surgery. The long-term use of GnRH was inappropriate.
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Affiliation(s)
- Marco Chiumente
- Scientific Direction, SIFaCT - Italian Society for Clinical Pharmacy and Therapeutics, Milan
| | - Mauro De Rosa
- Board of directors, SIFaCT - Italian Society for Clinical Pharmacy and Therapeutics, Milan
| | - Andrea Messori
- Board of directors, SIFaCT - Italian Society for Clinical Pharmacy and Therapeutics, Milan
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Moroni RM, Martins WP, Messina MDL, Ferriani RA, Peregrino P, Rosa-e-Silva JC, Nogueira AA, Brito LG. High-intensity focused ultrasound for symptomatic uterine fibroids. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Rafael M Moroni
- University of Sao Paulo; Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto; Avenida Bandeirantes, 3900, 8th floor ? Monte Alegre Ribeirao Preto Ribeirao Preto Brazil 14049-900
| | - Wellington P Martins
- University of Sao Paulo; Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto; Avenida Bandeirantes, 3900, 8th floor ? Monte Alegre Ribeirao Preto Ribeirao Preto Brazil 14049-900
| | - Marcos de Lorenzo Messina
- School of Medicine, University of São Paulo; Department of Obstetrics and Gynecology; Avenida Doutor Eneas de Carvalho Aguiar, 255 Sao Paolo Brazil 05403-010
| | - Rui A Ferriani
- University of Sao Paulo; Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto; Avenida Bandeirantes, 3900, 8th floor ? Monte Alegre Ribeirao Preto Ribeirao Preto Brazil 14049-900
| | - Pedro Peregrino
- University of Sao Paulo; School of Medicine; Avenida Doutor Eneas de Carvalho Aguiar, 255 Sao Paulo Brazil 05403-010
| | - Julio Cesar Rosa-e-Silva
- University of São Paulo; Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto; Avenida Bandeirantes 3900 Ribeirão Preto Brazil 14049-900
| | - Antonio Alberto Nogueira
- Medical School of Ribeirão Preto, University of São Paulo; Department of Obstetrics and Gynecology; Avenida dos Bandeirantes, 3900 Ribeirão Preto Brazil 14049-900
| | - Luiz Gustavo Brito
- State University of Campinas (UNICAMP); Department of Gynecology and Obstetrics; Rua Alexander Fleming, 101 Cidade Universitária Zeferino Vaz Campinas Sao Paulo Brazil 13083-881
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Chen H, Xu H, Meng YG, Zhang Y, Chen JY, Wei XN. miR-139-5p regulates proliferation, apoptosis, and cell cycle of uterine leiomyoma cells by targeting TPD52. Onco Targets Ther 2016; 9:6151-6160. [PMID: 27785063 PMCID: PMC5067016 DOI: 10.2147/ott.s108890] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Uterine leiomyoma is one of the most common benign tumors in women. It dramatically decreases the quality of life in the affected women. However, there is a lack of effective treatment paradigms. Micro-RNAs are small noncoding RNA molecules that are extensively expressed in organisms, and they are interrelated with the occurrence and development of the tumor. miR-139-5p was found to be downregulated in various cancers, but its function and mechanism in uterine leiomyoma remain unknown. The aim of this study was to investigate the role of miR-139-5p and its target gene in uterine leiomyoma. Methods By using a bioinformatic assay, it was found that TPD52 was a potential target gene of miR-139-5p. Then, expressions of miR-139-5p and TPD52 in uterine leiomyoma and adjacent myometrium tissues were evaluated by quantitative real-time polymerase chain reaction and Western blot. Proliferation, apoptosis, and cell cycle of uterine leiomyoma cells transfected by miR-139-5p mimics or TPD52 siRNA were determined. Results It was observed that the expression of miR-139-5p in uterine leiomyoma tissues was significantly lower (P<0.001) than that in the adjacent myometrium tissues. Overexpression of miR-139-5p inhibited the growth of uterine leiomyoma cells and induced apoptosis and G1 phase arrest. Dual-luciferase reporter assay and Western blot validated that TPD52 is the target gene of miR-139-5p. Furthermore, downregulation of TPD52 by siRNA in uterine leiomyoma cells inhibited cell proliferation and induced cell apoptosis and G1 phase arrest. Conclusion Data suggested that miR-139-5p inhibited the proliferation of uterine leiomyoma cells and induced cell apoptosis and G1 phase arrest by targeting TPD52.
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Affiliation(s)
- Hong Chen
- Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi
| | - Hong Xu
- Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi
| | - Yu-Gang Meng
- Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi
| | - Yun Zhang
- Department of Gynaecology, The People's Hospital of Suzhou High Tech District, Suzhou, Jiangsu, People's Republic of China
| | - Jun-Ying Chen
- Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi
| | - Xiao-Ning Wei
- Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi
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