Efficacy and safety of different doses of mifepristone in the treatment of uterine fibroids: A meta-analysis

Objective: To systematically assess the safety and effectiveness of mifepristone at doses of 2.5 mg, 5 mg, 10 mg, 25 mg, and 50 mg in the treatment of uterine fibroids. Methods: The protocol is registered with INPLASY (registration number is INPLASY202460075). Computer retrieval PubMed, the Cochrane Library, Embase database related (mifepristone group) compared to placebo and mifepristone or conventional treatment (control group) in the treatment of uterine fibroids randomized controlled trial (RCT), retrieve the time limit for a Library to in October 2023, Refer to the Cochrane faced the quality evaluation of the literature of included in the 6.0 and uses the RevMan 5.4.1 software Meta-analysis and sensitivity analysis. Results: There were 18 studies with a total of 2066 patients as participants. A meta-analysis found that the patients in the mifepristone group had lower uterine volume or uterine fibroid volume than the control group, with a statistically significant difference. Mifepristone treatment for 3 months uterine volume smaller is better than 6 months the difference is statistically significant. Compared with the control group, mifepristone can improve pelvic pain, pelvic pressure, bladder pressure, urinary symptoms, lower back pain, dyspareunia, rectal pain, menorrhagia, hypermenorrhea, and other clinical symptoms. The Mifepristone group had hot flashes, endometrium thickness increases, the incidence of hepatic transaminases associated is significantly higher than the control group, the patients in the 10 mg/d mifepristone group had endometrial thickness that was greater than those in the 5 mg/d mifepristone group. Conclusions: Mifepristone reduces fibroid volume and improves clinical symptoms, and 5 mg/day of mifepristone for three months may be the optimal clinical regimen.