Mifepristone shows therapeutic promise in adenomyosis

Use of mifepristone in the treatment of patients with adenomyosis appears to be safe and efficacious, reducing pain and inducing dysmenorrhea remission, as reported in a study.

The study included 134 patients with adenomyosis pain symptoms. They were randomly assigned to receive mifepristone 10 mg or placebo orally once a day for 12 weeks. 

The primary endpoint was the change in adenomyosis-associated dysmenorrhea intensity, assessed using the visual analogue scale (VAS) after 12 weeks of treatment. Secondary endpoints were the change in menstrual blood loss, increased level of haemoglobin in patients with anaemia, CA125 level, platelet count, and uterine volume after 12 weeks of treatment. Safety was evaluated according to adverse events, vital signs, gynaecological examinations, and laboratory evaluations.

Of the patients, 126 were included in the efficacy analysis, including 61 in the mifepristone group (mean age 40.2 years) and 65 in the placebo group (mean age 41.7 years; p<0.001).

At week 12, the total remission rates for dysmenorrhea were significantly higher in the mifepristone group than in the placebo group (effective remission: 91.8 percent vs 23.1 percent; complete remission: 88.5 percent vs 6.2 percent).

Compared with placebo, mifepristone treatment also led to significant improvements in all the secondary endpoints, including menstrual blood loss, haemoglobin (mean change, 2.13 vs 0.48 g/dL; p<0.001), CA125 (mean change, −62.23 vs 26.89 U/mL; p<0.001), platelet count (mean change, −28.87 vs 2.06 ×10³/µL; p<0.001), and uterine volume (mean change, −29.32 vs 18.39 cm³; p<0.001).

Safety data showed no significant difference between groups, and none of the patients experienced serious adverse events.