{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:10:56Z","timestamp":1767651056901},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T00:00:00Z","timestamp":1560902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Uterine fibroids cause menorrhagia and adversely affect quality of life. Ulipristal acetate (<jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content>) can improve fibroid symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the effectiveness of <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> in women with symptomatic uterine fibroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>We searched <jats:styled-content style=\"fixed-case\">CENTRAL<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> MEDLINE<\/jats:styled-content>, Embase, and <jats:styled-content style=\"fixed-case\">CINHAL<\/jats:styled-content> on December 31, 2018, using relevant search terms. Clinical trials registries were searched for ongoing trials and there were no language restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>We included randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) comparing <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> with placebo\/no treatment\/any pharmacological intervention for symptomatic uterine fibroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two authors independently screened trials, extracted data, and assessed the risk of bias in included studies. We used risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) for dichotomous outcomes and mean difference (<jats:styled-content style=\"fixed-case\">MD<\/jats:styled-content>) for continuous outcomes, plus their 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>We identified six <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s (1121 participants). Five studies (882 participants) compared <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> with placebo. <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> significantly achieved amenorrhea (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 24.54; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 10.82\u201355.64), reduced blood loss, and improved quality of life with insufficient evidence from <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s for adverse events. There was insufficient evidence for improved outcomes when <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> was compared with leuprolide acetate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with placebo, oral <jats:styled-content style=\"fixed-case\">UPA<\/jats:styled-content> significantly induces amenorrhea, reduces heavy menses, and improves quality\u2010of\u2010life in women with uterine fibroids.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12868","type":"journal-article","created":{"date-parts":[[2019,5,25]],"date-time":"2019-05-25T09:00:32Z","timestamp":1558774832000},"page":"141-148","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["A systematic review and meta\u2010analysis of ulipristal acetate for symptomatic uterine fibroids"],"prefix":"10.1002","volume":"146","author":[{"given":"Mohamed","family":"Ghonim","sequence":"first","affiliation":[{"name":"Extended Modular Program Faculty of Medicine Ain Shams University  Cairo Egypt"},{"name":"Egyptian Center for Evidence Based Medicine  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Magdy","sequence":"additional","affiliation":[{"name":"Extended Modular Program Faculty of Medicine Ain Shams University  Cairo Egypt"},{"name":"Egyptian Center for Evidence Based Medicine  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Sabbour","sequence":"additional","affiliation":[{"name":"Extended Modular Program Faculty of Medicine Ain Shams University  Cairo Egypt"},{"name":"Egyptian Center for Evidence Based Medicine  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohanad","family":"Ghonim","sequence":"additional","affiliation":[{"name":"Extended Modular Program Faculty of Medicine Ain Shams University  Cairo Egypt"},{"name":"Egyptian Center for Evidence Based Medicine  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Nabhan","sequence":"additional","affiliation":[{"name":"Egyptian Center for Evidence Based Medicine  Cairo Egypt"},{"name":"Department of Obstetrics and Gynecology Faculty of Medicine Ain Shams University  Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2017.10.001"},{"key":"e_1_2_8_3_1","first-page":"CD010770","article-title":"Selective progesterone receptor modulators (SPRMs) for uterine fibroids","volume":"4","author":"Murji A","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/11209400-000000000-00000"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.02.008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.04.025"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2018.1417389"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gan004"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002942"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002462"},{"key":"e_1_2_8_12_1","unstructured":"European Medicines Agency.EMA\/482522\/2018 \u2010 Esmya: new measures to minimise risk of rare but serious liver injury.http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Referrals_document\/Esmya_20\/European_Commission_final_decision\/WC500253487.pdf. 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