Extending the Nonsurgical Management of Fibroid-Associated Heavy Menstrual Bleeding

Twelve months of elagolix plus estradiol-progestin controlled heavy menstrual bleeding with few adverse effects.

Elagolix, an oral gonadotropin-releasing hormone (GnRH) antagonist approved for endometriosis-associated pelvic pain, represents an option for nonsurgical management of uterine fibroids. In an industry-sponsored placebo-controlled trial, 6 months of elagolix alone or with estradiol-progestin add-back therapy effectively controlled heavy menstrual bleeding in women with such fibroids (NEJM JW Womens Health Feb 2020 and N Engl J Med 2020; 382:328). The trial was extended for 433 women treated with 300-mg elagolix twice daily alone or plus hormone add-back (once-daily 1-mg estradiol and 0.5-mg norethindrone acetate).

At 12 months, heavy menstrual bleeding was controlled in women receiving elagolix plus add-back (88%) and elagolix alone (89%). A…

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Extending the Nonsurgical Management of Fibroid-Associated Heavy Menstrual Bleeding

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Reviewing Author