Efficacy and tolerability of CDB-2914 treatment for symptomatic uterine fibroids: a randomized, double-blind, placebo-controlled, phase IIb study

Objective: To evaluate the efficacy and tolerability of the P receptor modulator CDB-2914 (Ulipristal, CDB). Design: Randomized, placebo-controlled double-blind clinical trial. Setting: Clinical research center. Patient(s): Premenopausal women with symptomatic uterine fibroids. Intervention(s): Once-daily oral CDB (10 or 20 mg) or placebo (PLC) for 12 weeks (treatment 1). A second 3-month treatment with CDB (treatment 2) was offered. A computer-generated blocked randomization was used. Main Outcome Measure(s): Magnetic resonance imaging (MRI)-determined total fibroid volume (TFV) change was the primary outcome; amenorrhea and quality of life (QOL) were secondary end points. Result(s): Treatment 1 TFV increased 7% in the PLC group, but decreased 17% and 24% in the CDB10 and CDB20 groups. The TFV decreased further in treatment 2 (-11%). Amenorrhea occurred in 20/26 women taking CDB and none on PLC. Ovulation resumed after CDB. Hemoglobin improved only with CDB (11.9 +/- 1.5 to 12.9 +/- 1.0 g/dL) as did the Fibroid QOL Questionnaire symptom severity, energy/mood, and concern subscores, and overall QOL scores. The CDB was well tolerated, with no serious adverse events. Adverse events were unchanged during treatments. Conclusion(s): Administration of CDB-2914 for 3-6 months controls bleeding, reduces fibroid size, and improves QOL. (Fertil Steril(R) 2011;95:767-72. (C) 2011 by American Society for Reproductive Medicine.)