From the Journals

Uterine fibroids registry looks to provide comparative treatment data



Early findings from a uterine fibroids registry suggest more than half of enrolled women chose an alternative to hysterectomy, underscoring the need to study the efficacy of these uterine-sparing treatment options, said Elizabeth A. Stewart, MD, of the Mayo Clinic, Rochester, Minn., and her associates.

There is very little evidence on the comparative efficacy of uterine fibroid treatment options so the COMPARE-UF (Comparing Options for Management: Patient-Centered Results for Uterine Fibroids) registry was initiated for women who choose procedural therapy for symptomatic uterine fibroids. Data at the nine clinical centers – representing rural and urban populations – are being collected regarding hysterectomy, myomectomy (abdominal, hysteroscopic, vaginal, and laparoscopic/robotic), endometrial ablation, radiofrequency fibroid ablation, uterine artery embolization, magnetic resonance–guided focused ultrasound, and therapeutic use of progestin-releasing intrauterine devices.

Uterine fibroids Courtesy Wikimedia Commons/Hic et nunc/CC BY-SA 3.0
Of the initial 2,031 women enrolled, hysterectomy was chosen by 38%. Myomectomies were chosen by 46% of women; laparoscopic or robotic myomectomies were picked most frequently, accounting for 19% of all procedures. Of the other procedures, 7% chose endometrial ablation, 6% chose uterine artery embolization, less than 1% chose radiofrequency fibroid ablation or magnetic resonance–guided focused ultrasound, and none chose the IUD.

A total of 16% of the women were under age 35, and 40% were aged 40 years or younger. “The fact that a sizable proportion of women are under age 40 suggests that with long-term follow-up, data on reproductive outcomes can be obtained as these women seek pregnancy,” Dr. Stewart and her associates noted.

Although African American women make up only 13% of the U.S. population, they constitute 42% of enrollment in COMPARE-UF, the investigators reported in the American Journal of Obstetrics and Gynecology. African American women chose similar or greater numbers of each type of myomectomy and uterine embolization as white women chose.

The study was supported by a grant from the Agency for Healthcare Research and Quality. The registry is supported by AHRQ and the Patient-Centered Outcomes Research Institute. Dr. Stewart reported personal fees from AbbVie, Allergan, Astellas, Pharma, Bayer, Gynesonics, and Myovant Sciences. Several researchers reported grants from pharmaceutical companies outside this study, and the remainder of the investigators reported no relevant financial disclosures.

SOURCE: Stewart EA et al. Am J Obstet Gynecol. 2018 May 8. doi: 10.1016/j.ajog.2018.05.004.

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